Home Dialysis

In the early years of dialysis, home dialysis was the rule rather than the exception. However, home dialysis began to lose ground in the 1980s. By the early part of this century, home dialysis use in the US was slightly above 9%, and fewer than 2000 patients performed home hemodialysis.

During the past 15 years, home dialysis has gradually experienced a renaissance. The launch of portable home hemodialysis equipment in 2004 started a long-run upswing in use of the modality, leading to more than 10,000 patients on home hemodialysis today and multiple machines either having obtained or nearing US Food and Drug Administration clearance. The launch of the ESRD Prospective Payment System in 2011 created a clear financial incentive for peritoneal dialysis, and use quickly increased. Most recently, the Executive Order on Advancing American Kidney Health set the stage for innovative payment models, including ESRD Treatment Choices, which offers financial bonuses to dialysis providers and nephrology practices for continuously increasing the use of home dialysis.

CDRG has a wealth of expertise in home dialysis analysis and research. Notably, CDRG has a deep understanding of both peritoneal dialysis and home hemodialysis, thanks to staff with years of experience not only in academic research but also in the home dialysis device industry. Highlights of past and ongoing work at CDRG include:

• Comparative effectiveness of peritoneal dialysis and in-facility hemodialysis
• Comparative effectiveness of intensive home hemodialysis with thrice-weekly in-facility hemodialysis
• Economic impact of home hemodialysis
• Evaluation of the expansion of the Centers for Medicare & Medicaid Services (CMS) Transitional Add-on Payment Adjustment for New and Innovative Equipment and Supplies to home dialysis equipment
• Analysis of the epidemiology of peritoneal dialysis technique failure

CDRG also has extensive experience with Medicare data and understands the intricacies of how home dialysis modalities and intensive hemodialysis treatments are documented, as well as how to derive key performance indicators from data. Notably, CDRG staff are experts on the ins and outs of ESRD Treatment Choices.

Whatever your vision for growing home dialysis, from developing new equipment to improving outcomes in a network of home dialysis programs, CDRG is your partner in analysis and research.

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