DPC submitted comments on Medicare’s proposed payment update for 2027. DPC urged CMS to change its current policies, which continue to cause financial stress to dialysis care, staffing shortages, and lack of patient access to new and innovative therapies.
For 2027, the Centers for Medicare & Medicaid Services (CMS) is proposing to increase the ESRD PPS base rate to $299.55, which will increase total payments to ESRD facilities by approximately 1.1%. However, DPC notes, the current inflation rate is 3.4%, the Wall Street Journal’s expert panel of economists forecasts 3.4% inflation for the next year, and the most recent producer price index was 4.7%. As such, DPC says that CMS’ forecast of just 2.6% inflation is as unrealistic as previous years’ updates: “We can expect health care sector workers to demand 3.4% pay increases in the next year, and find other work if providers can’t offer them.”
The letter observes that the number of U.S. dialysis facilities closing has been rising since 2018. In 2024 there were 56 facility openings vs. 74 facility closures. “This change in trend over the past 5 years coincides with the string of update Medicare deficiencies, which can be traced back to 2019 since when the difference between forecast costs and actual costs has been a cumulative 6 percent.”
DPC also criticized the Rule for again failing to address the perverse effects of strict bundling on access to new therapies. “Our review of the press releases CMS has put out about beneficiary access to drugs and devices finds many diseases and drugs specifically mentioned: sickle cell and asthma, CAR T-cell treatments, GLP-1 drugs and small biotech drugs. Digital health devices are called out as are even Botox and hemp-derived products. But one category that’s never been mentioned is drugs for dialysis patients.”
