Atlantic Dialysis Management Services, LLC, College Point, NY; Departments of Medicine & Physiology, Xavier University School of Medicine, Oranjestad, Aruba.
Atlantic Dialysis Management Services, LLC, College Point, NY.
Adv Chronic Kidney Dis. 2022 Jan;29(1):45-51. doi: 10.1053/j.ackd.2022.01.001.
The ETC model proposes to increase access to home dialysis and transplant for patients with ESRD. Implementation of this model is happening while many dialysis organizations are still suffering the far-reaching effects of the coronavirus disease 2019 (COVID-19) pandemic. In addition, the model has the potential to negatively affect small and independent dialysis organizations disproportionately. It incentivizes home dialysis over transplant and promotes development of new home dialysis programs, rewards achievement over improvement, and places an excessive burden on small and independent dialysis organizations. Advantages of the program include the focus on self-care as an acceptable alternative to home dialysis for some patients and the potential for some organizations to make improvements in care with increased reimbursements. The authors hope that the Centers for Medicare and Medicaid Services will address many of these concerns in updated rulemaking and guidance.
ETC 模式旨在增加终末期肾病患者的家庭透析和移植机会。在许多透析组织仍在受 2019 年冠状病毒病（COVID-19）大流行深远影响的同时，该模型正在实施。此外，该模型有可能不成比例地对小型和独立透析组织产生负面影响。它鼓励家庭透析而非移植，并促进新的家庭透析计划的发展，奖励成果而非改进，并给小型和独立透析组织带来过重负担。该计划的优点包括关注自我护理，因为对于一些患者来说，自我护理是家庭透析的可接受替代方案，并且一些组织有可能通过增加报销来改善护理。作者希望医疗保险和医疗补助服务中心在更新的法规制定和指导中解决这些问题。
