OPINION:
My home state of West Virginia is one of the most rural in our country. Its rolling hills, beautiful streams, and forests stretch for miles. On clear nights, our West Virginia skies are bright with stars. It is a unique kind of beauty only found in the more secluded areas of the world. However idyllic, this seclusion comes at a price, especially for individuals seeking medical care. For some of my constituents, it is not uncommon for the nearest hospital to be several hours away, only accessible by traveling mountainous roads and through low-lying “hollers.” This creates a unique barrier to care that affects an already vulnerable population.
As a Member of the Ways and Means Health Subcommittee and Co-Chair of the Congressional Kidney Caucus, I have spent a good deal of my time in Congress addressing the needs of West Virginians suffering from Chronic Kidney Disease (CKD) and improving access to treatments for this disease. Nationally, 37 million Americans suffer from CKD and 500,000 Americans are battling End Stage Renal Disease (ESRD), which requires them to travel multiple times a week for dialysis at a medical center. This places undue stress on an individual already having to endure a debilitating disease.
Recently, I introduced the Improving Home Dialysis Act which would ease the hardships of patients opting for home dialysis by allowing Medicare to reimburse for additional support services, including staff-assisted home dialysis respite care for patients who need temporary assistance with treatment and renal mental health services to help patients successfully transition to home dialysis.
Studies have shown that receiving dialysis treatments at home results in faster recovery with fewer side effects, improved cardiac status, and increased life expectancy. Lack of knowledge and experience as well as physical injuries and limitations can prevent patients from choosing to dialyze at home and therefore lose or miss the benefits this can bring. By allowing Medicare to cover staff-assisted home dialysis education and assistance, we can give patients the confidence and ability to safely and independently dialyze in the comfort of their home.
Equally important to ensuring patients have the skills and knowledge to self-dialyze, it is also crucial that we help them navigate the logistical complexities and emotional toll ESRD and dialysis can bring. Patients diagnosed with ESRD are three times more likely to experience serious psychological distress and are twice as likely to have anxiety and depression compared to the general population.
Because of this, dialysis facilities employ qualified renal mental health professionals to assist struggling patients. Unfortunately, this care is not consistently available to home dialysis patients. Those choosing to dialyze at home should have the same access to quality support services as someone receiving dialysis in-center. Patients should not be penalized for choosing a treatment that often provides greater flexibility, independence, and quality of life. This is especially true for my rural patients in West Virginia where the nearest healthcare facility could be an hourslong commute away.
For rural patients like those in West Virginia and similar areas of our country, the ability to dialyze at home is more than just a convenience. It ensures improved access to quality, lifesaving medical care, free of the roadblocks that difficult terrain and increased drive times so often create. Currently, Medicare does cover limited support services to facilitate home dialysis care. My legislation would expand the current offerings and allow Medicare to cover crucial, life-changing services that improve patient outcomes. The Improving Home Dialysis Act is an important step toward helping more Americans successfully transition to and remain on home dialysis.
• Rep. Carol Miller represents West Virginia’s First Congressional District. Miller serves on the Committee on Ways and Means. Miller’s focus in Congress is creating jobs, diversifying the economy, investing in trade relations, improving access to healthcare for rural and ultra-rural communities, and supporting West Virginia’s energy industries like coal, oil, and gas. Prior to her election to Congress in 2018, Congresswoman Miller served in the West Virginia House of Delegates from 2006 to 2018 where she rose to become the first female Majority Whip.
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