HCFA Announces New Steps for Racial Equality in Kidney Transplantation
Contact: HCFA Press Office, 202-690-6145;
Web sites: http://www.hcfa.gov or http://www.hhs.gov
WASHINGTON, Nov. 24 /U.S. Newswire/ -- The Health Care Financing Administration announced today that the Medicare program is taking new steps to ensure that all patients with renal failure, regardless of race or ethnicity, are being evaluated for kidney transplantation.
The effort will include communication, enforcement and technical assistance to dialysis centers, which are required by regulation to assure that all patients in the facility are assessed for and fully informed about their suitability for transplantation as part of the patient's long-term care plan.
"Medicare rules require that all patients with kidney failure be evaluated and informed about transplantation," said HCFA Administrator Nancy-Ann DeParle. "We want to be sure this is happening and be sure there is equal opportunity for transplantation when needed, regardless of a patient's race."
The Medicare program provides insurance coverage for most Americans with permanent kidney failure, paying for dialysis treatment and transplantation through the End State Renal Disease (ESRD) program. Medicare covers a total of 310,000 ESRD patients, with estimated fiscal year 1999 spending of $11.8 billion.
HCFA's announcement was made as a study by John Ayanian, M.D., and colleagues at Harvard Medical School appeared in the New England Journal of Medicine. The investigators interviewed a sample of patients with kidney failure and found that black end stage renal disease (ESRD) patients were less likely than white ESRD patients to want a transplant (76.3 percent vs. 79.3 percent among women, and 80.7 percent vs. 85.5 percent among men).
Racial differences were substantially greater in rates of referral for a transplant evaluation (50.4 percent for black woman and 70.5 percent for white women, and 53.9 percent for black men vs. 76.2 percent for white men) and placement on a waiting list for transplantation within 18 months after starting dialysis (31.3 percent for black women vs. 56.5 percent for white women, and 35.3 percent for black men vs. 60.6 percent for white men). These racial differences remained significant after adjusting for patients' preferences and expectations about transplantations, sociodemographic characteristics, health status, perceptions of care and comorbid illnesses.
Medicare will take a three-pronged approach to addressing transplant assessment disparities:
First, the program will remind all certified dialysis facilities of its requirements that all ESRD patients are to be assessed for and fully informed about transplantation as part of the patient's long-term care plan.
Second, HCFA will work with the State Survey Agencies in evaluating the study findings and paying particular attention to dialysis facility compliance with regulations. State Survey Agencies inspect ESRD and other health care facilities to determine their compliance with Medicare certification requirements.
Finally, Medicare will work with the ESRD Network Organizations to identify ways that the Networks can work with the patients, the renal community, and the dialysis facilities in their area to increase transplant assessment rates. ESRD Network Organizations monitor the quality of care provided in dialysis facilities and assist facilities to improve patient care as opportunities present themselves.
"All three approaches will enforce and reinforce Medicare's commitment to its ESRD beneficiaries by assuring that they will receive the quality of care that they depend on, including the opportunity to be fully informed about and assessed for transplantation," DeParle said.
------ Note: For other HHS Press Releases and Fact Sheets pertaining to the subject of this announcement, visit the Press Release and Fact Sheet search engine at: http://www.os.dhhs.gov/news/press/
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/U.S. Newswire 202-347-2770/
11/24 17:00
Copyright 1999, U.S. Newswire
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