Not many MPH students get to see the results of their internship work covered in the New York Times, but Ms. Danielle Raso was one of the lucky few. The payment models Ms. Raso worked on with the Center for Medicare and Medicaid Innovation (CMMI) in Woodlawn, Maryland were rolled out via an executive order from President Trump on July 10, directing reforms to dialysis and kidney disease treatment.
End Stage Renal Disease (ESRD has remained unique as the only condition that specifically makes patients eligible for Medicare, and in 2016, care for Medicare beneficiaries with Chronic Kidney Disease and ESRD accounted for $114 billion in total Medicare expenditures. The new models that Ms. Raso worked on shifts financial incentives for providers away from receiving dialysis in dialysis centers and towards in-home dialysis, which is both less expensive and offers a better quality of life for patients. Additionally, the models waive certain Medicare requirements to make kidney disease patient education more available and incentivize providers to facilitate kidney transplants, which are preferred by most patients. The mandatory model released through the rule will affect approximately 50 percent of the country, and many more providers will be able to join the voluntary models.
Ms. Raso, a student in the Department of Health Policy and Management at Yale School of Public Health, was able to work on the policies before they were announced and is working on materials explaining the structure and specifics of the models for participants and the public. She describes seeing language she wrote in a rule as surreal and is grateful to have been placed on such a great team within CMMI.Tags: Friday Letter Submission, Publish on August 02