In a Friday, October 4, Washington Post opinion piece, former White House Office of Science and Technology Policy staffer Jennifer Erickson calls for a reform of the current United States organ procurement system. Erickson cites research that "thousands of organs go unrecovered every year from potential donors across the country." These missed opportunities for organ recovery occur, she argues, due to mismanagement by organ procurement organizations (OPOs), the nonprofit government contractors responsible for organ procurement and placement. Because OPOs self-report their own performance data, the reporting is “functionally useless” with “no system accountability,” said Erickson’s former colleague from the Obama administration U.S. Chief Data Scientist DJ Patil.
ASN has urged the Centers for Medicare and Medicaid Services (CMS) Survey and Certification Group to delay implementation and foster dialogue regarding a policy concerning saline syringe filling practices. The policy is set to take effect by Sunday, July 2, 2017. Addressed to state survey agency directors, the memorandum states that “ESRD facilities may not fill syringes with saline from the single dose saline bag or IV tubing connected to the patient at the dialysis station” whenever possible. Emphasizing ASN’s commitment to the goal of ensuring patient safety, the society expressed reservations about the memorandum’s recommendations, including concerns about the evidence base for and potential unintended consequences of the new policy, as well as its cost-effectiveness. In a letter from President Eleanor D. Lederer, MD, FASN, ASN encouraged CMS to delay implementation to allow time for public discussion of best practices, including patient and health professional organizations, dialysis providers, and the Centers for Disease Control and Prevention (CDC) – observing that such communication has resulted in implementation of beneficial policies with broad support in the past. “In the absence of any evidence suggesting that pre-filled syringes are an effective strategy to reduce infections, I am concerned that this approach will not necessarily lead to better outcomes despite increasing costs. Before proceeding with nationwide implementation, I believe at the very least CMS should provide an opportunity for all stakeholders, including the CDC, to discuss this new approach. Ideally, a well-powered trial to establish some science on this approach would be funded so that we are implementing evidence-based policy instead of policy that ‘sounds good,’” said ASN Quality Committee Chair Daniel E. Weiner, MD, FASN. As of press time, CMS had not yet responded to ASN’s concerns. Read the society’s complete letter to CMS is online at: https://www.asn-online.org/policy/
Last week, ASN joined other kidney community stakeholders to meet with leadership at the Centers for Medicare and Medicaid Services (CMS) in Baltimore, MD, to discuss the future of the ESRD Prospective Payment System—more commonly known as “the bundle”—that provides reimbursement for dialysis care. Together with representatives from kidney patient organizations, dialysis organizations, and device manufacturers, ASN discussed with CMS the need for a mechanism to add new products to the bundle.
Policymakers and public health officials are sounding the alarm about the opioid overdose crisis nationwide. More than 115 people die each day due to opioid-related drug overdoses, and the Department of Health and Human Services (HHS) Secretary Alex Azar has made combatting this epidemic one of his top priorities.
One of the keys to success in reducing the fight against opioid-related deaths is ensuring patients and their families have access to safe alternatives to manage pain. ASN is working in partnership with other advocates in Washington—including the American Association of Kidney Patients (AAKP) and the Renal Physicians Association (RPA) to ensure alternatives exist for people affected by kidney diseases.