3. ESRD Choice Act of 2016
Introduced on Thursday, July 7 by: Jason Smith (MO-08), John Lewis (GA-05), Gus Bilirakis (FL-12),
Kurt Schrader (OR-05) and Tom Marino (PA-10)
Purpose:
Pulled out the Medicare Advantage piece of the broader Kidney Bill.
News:
It’s being marked up today! This is very exciting and a huge step forward (and so quick!)
for this legislation. The House Ways and Means committee will be “marking up” the bill (revising
and amending) and then vote to send the bill back to the full house. It’s set to take place at
around 2:00 EST.
5. What is it?
• The Dialysis PATIENT Act
• Patient Access to Integrated-care, Empowerment, Nephrologists, and Treatment
• For those of you who joined us in April in DC or on the call before our in-person advocacy day,
this is the legislation to accompany our message—”Support integrated care for dialysis patients”
• Introduced in the house as H.R. 5506 by Todd Young (IN-09), Earl Blumenauer (OR-03), Cathy
McMorris-Rodger (WA-05), and Tony Cardenas (CA-29)
• Since introduction on 6/16, 9 co-sponsors have been added:
Kyrsten Sinema (AZ-09)
Brenda Lawrence (MI-14)
Brett Guthrie (KY-02)
Ryan Costello (PA-06)
Yvette Clarke (NY-09)
Filemon Vela (TX-34)
Renee Ellmers (NC-02)
Charles Boustany (LA-03)
Billy Long (MO-07)
• A senate companion was also introduced as S. 3090 by Senator Dean Heller (NV) and Bill Nelson (FL)
6. What will it do?
• Establishes an ESRD Integrated Care Demonstration Program within Medicare to expand
coordinated care. This demonstration adds a new capitated payment model to promote use of
innovative care techniques and hold providers accountable for costs and quality.
• Services that could be included in a demonstration:
• Intervention to prevent complications
• Transition from the hospital to the community
• Managing co-morbidities
• Medication reconciliation
• Increased engagement of patients in their care
7. But what about ESCOs?
• You may be thinking “I thought we already had this with the ESCOs. What is the difference?”
• You are correct! ESRD Seamless Care Organizations allow dialysis facilities to provide integrated care services,
however enrollment in the ESCO program is limited.
• In order to participate in an ESCO, all of the partners (dialysis facility, nephrology practice, etc.) must bear all financial risk of
providing these services. They have to have the financial capital to provide integrated care and then get “refunded” if health
outcomes are better than average.
• This demonstration gives participants a payment per patient up front. Then, if health outcomes are
WORSE than expected they will return the “loss.”
• Key takeaway: the payment per patient up front could allow more facilities to participate in this type
of program as opposed to having the capital to “invest” in an ESCO.
• Having many different types of care models to try will only benefit patients in the long run.
8. Grassroots Efforts
• After the bill was introduced we sent a stand alone action alert, as well as included a link to the
action alert in the July DPC E-Newsletter.
• To date:
• 706 messages! 697 emails and 9 tweets
• 164 House offices (38%)
• 86 Senate offices (86%) [ND, AK, HI, MT, RI, VT, NH]
9. August Recess
• Starting next week the house will be in recess until after Labor day. This means they will be
spending a lot of time at home, in district.
• This provides a great opportunity to schedule a district meeting with your legislator(s) about the
Dialysis Patient Act and the Medicare Advantage Bill
11. Scheduling a District Meeting
• You can find your representative’s district
office information by visiting our website.
• Take note of the office information for follow
up purposes
• We suggest the initial contact be made via
email. Notice the staff member’s email isn’t
listed…but if you email me the staff name I
can retrieve it for you and send you text you
can use for the request.
12. Making the Request
• Look at your schedule to determine which days work best for you. Flexibility is key! If you are a
MWF dialysis patient suggesting any Tuesday or Thursday (noting any exceptions) in August will
be the best way to secure a meeting.
• Ask family/caregivers or a friend in your facility to join you. If you do have someone who would
like to join you, include that in your request.
• Email the scheduler/office coordinator a message like this:
13. Making the Request
• Look at your schedule to determine which days work best for you. Flexibility is key! If you are a
MWF dialysis patient suggesting any Tuesday or Thursday (noting any exceptions) in August will
be the best way to secure a meeting.
• Ask family/caregivers or a friend in your facility to join you. If you do have someone who would
like to join you, include that in your request.
• Email the scheduler/office coordinator a message like this:
To: jane.doe@mail.house.gov
From: klukaszewski@dialysispatients.org
Subject: Meeting Request
-----------------------------------------------------------------------------------------------------------------------
Dear Ms. Doe,
I am writing to request a meeting with Representative Miller while she is in the district to discuss two pieces of legislation very
important to me. I am an ESRD patient, meaning I need dialysis treatments to survive. The Dialysis PATIENT Act (H.R. 5506/ S.3090) as
well as the ESRD Choice Act (H.R. 5659) have ways to improve my health through care coordination and expanded insurance choice.
I am available to meet with Rep. Miller any Tuesday or Thursday in August with the exception of Aug. 11.
Please contact me with any questions via phone at 202-789-6931 or via email.
Thank you for your time, I look forward to hearing from you.
Sincerely,
Kristy Lukaszewski
14. Follow Up/ Holding the Meeting
• After you send the initial request, follow up via phone or email the following week. Follow up is key
to securing you get on the schedule.
• Once you are on the schedule attend your meeting! Protocol is identical to that in Washington, D.C.
• Arrive early, call the office if you are running late
• Stick to the issue, don’t let other political concerns intrude on your meeting
• Don’t be afraid to not know everything! If you can’t answer one of their questions, tell them you will look into it and follow up
with the answer as soon as possible.
• Share your story as a patient! This is the most powerful part of the meeting and what will likely stick with the
representative or their staff member most.
• Consider how coordination of care could help you or others you see in your facility
• How could having access to Medicare Advantage help you financially?
• Leave any materials you have (DPC will provide fact sheets) and take note of any follow ups they request.
• Thank them for taking the time to meet with you, make sure you get a business card to send a formal thank you
afterward!
15. After the Meeting
• Send the staff person you met with (or legislator themselves!) a thank you note for taking the
time to meet with you.
• Let me know how the meeting went and if they had any questions that need to be followed up
on.
• It’s important for us to know how these meetings go so when we meet with the office again in DC we
know what questions they had or what information they need to support our efforts!
16. Summary
• Two exciting pieces of legislation are in the pipeline: the Dialysis PATIENT Act and the ESRD
Choice Act
• Both provide access to coordination of care, one through a demonstration project the other
through access to Medicare Advantage plans
• The summer recess begins next week which will provide you the perfect opportunity to meet
with legislators at home about these important bills
• Let me know if you are interested in holding a district meeting and I can provide you the email
for the office as well as text to use or email on your behalf
• Have great summer meetings!
