Letter from Kidney Care Partners (of which ANNA is a member) to Senators Grassley and Baucus (Senate Committee on Finance) thanking them for introducing the Medicare Value Purchasing Act of 2005

October 6, 2005

The Honorable Charles E. Grassley
United States Senate Committee on Finance
135 Hart Senate Office Building
Washington, DC  20510

The Honorable Max Baucus
Ranking Member
United States Senate Committee on Finance
511 Hart Senate Office Building
Washington, DC  20510

Dear Chairman Grassley and Ranking Member Baucus:

Kidney Care Partners (KCP), the most comprehensive alliance of patients, health care professionals, dialysis providers, and suppliers in the kidney care community, endorses value-based purchasing in health care, and we thank you for your leadership on this important issue. Our members are committed to quality, and we applaud you for introducing the Medicare Value Purchasing Act of 2005, which makes a critical link between Medicare payments and quality performance.

The kidney care community believes that measuring and reporting on quality performance stimulates improvement. In fact, dialysis providers have been measuring and reporting on quality for several years. In 1995, the kidney care community defined clinical outcomes for end-stage renal disease (ESRD) through the Dialysis Outcomes Quality Initiative (DOQI), now called K/DOQI. This initiative, as you know, is coordinated through the National Kidney Foundation. That process led to the development of clinical practice guidelines, which have had a significant and positive impact on the quality of patient outcomes. Additionally, the Centers for Medicare and Medicare Services plays an important role in collecting and reporting quality data on dialysis care. ESRD facilities have voluntarily submitted quality data without payment to CMS since 1994 as part of the ESRD Core Indicators Project, which is part of the ESRD Health Care Quality Improvement Program. This was CMS's first nationwide, population-based study designed to improve the care of patients with ESRD.  For example, according to CMS the percentage of patients’ with hemoglobin levels > 11 gm/dL rose from 43 percent in 1997 to 80 percent in 2003. Similarly, the percentage of patients with Kt/V > 1.2 (a measure of dialysis quality) has risen to 91 percent from 74 percent when first measured in 1996.  Renal dialysis facilities have a strong record when it comes to reporting patient outcomes and improving them; however, we understand that more can be done.

We commend your leadership on this vital issue for Medicare beneficiaries. Your legislation represents an important step forward on quality by linking Medicare payment to quality performance measures. KCP endorses your approach, and we urge you to consider the unique situation of the dialysis provider segment, which has no automatic annual payment update. We would be happy to work with you to resolve that anomaly as you move forward with this legislation. 

Thank you for your support of patients with ESRD and for your commitment to improving the quality of patient care for all Medicare beneficiaries. 


Kent J. Thiry
Chairman of the Board
Kidney Care Partners