Get the Facts Kentucky

Chronically ill people suffering from kidney disease face significant hurdles accessing the quality care they need because of big insurance companies' unfair practices.

As a result, people may be forced to change their own dialysis center- where the nurses and dialysis techs know them personally, not just as patients.  Where nurses understand their specific individual care needs. Instead patients could be forced to travel long distances for care, making it tough to get to work and care for their families.  Traveling long distances for care can cause tremendous family hardships and burden friends who many patients rely on for help.

This isn't right. It is wrong for insurance companies to discriminate against a small group of very ill patients.

The Facts

People on dialysis have lost normal kidney function. End Stage Renal Disease (ESRD) is irreversible and fatal without life-long treatment. Dialysis is the only thing keeping them alive.

Nationally, there are more than 350,000 kidney patients on dialysis, and nearly 4,500 are Kentuckians.

ESRD disproportionately affects minority communities: African Americans make up only 13% of the U.S. population, yet they represent 37% of dialysis patients. Hispanic Americans are 4-6 times more likely to develop Chronic Kidney Disease (CKD) than non-Hispanics. Further, and the rate of kidney disease among Native Americans with diabetes is 6 times higher than among non-Native Americans.

Dialysis patients are an extraordinarily vulnerable population with significant health care needs. Most patients must receive dialysis treatment 3 times a week in sessions lasting 3-4 hours each just to survive.

Across the country and in the Commonwealth, kidney disease is on the rise due in large part to the increase in conditions that lead to kidney disease: diabetes, hypertension and obesity.

The Issues: Major Impact on Patients.

Dialysis is the only chronic illness in the country that lets insurance companies off the hook. After 30 months Medicare assumes responsibility for dialysis patients' treatment and benefits, regardless of age. Prior to that, patients rely upon their private insurance plan to pay for their care.

Dialysis patients, with a PPO insurance plan, have agreed to pay higher premiums and co-pays to have the right to choose where they receive their care.

To try to increase their profits, insurance companies have started limiting that freedom of choice, restricting patient access to out-of-network medical care by drastically reducing payments to those providers who are not in their networks.

This aggressive tactic by insurance companies replaces the normal negotiation between the centers that provide dialysis treatment and insurance companies and essentially forces centers to join their network or to turn away patients.

These insurance company tactics create a situation where patients have paid higher PPO premiums for the ability to choose where they receive their care, only to have that choice limited by insurance companies when they need it most.

However, dialysis patients only represent 1 out of every 5,000 people covered by insurance companies.

Payments for dialysis care are just a drop in the bucket compared to the big insurance companies' profits, yet this care mean so much to people suffering from chronic kidney disease and dealing with dialysis.