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SGR fix also expands role of advanced practice nurses - NephrologyNews.com |
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The legislation passed by the Senate April 14 that would permanently remove the sustainable growth rate formula, also allows nurse practitioners and clinical nurse specialists to document the face-to-face encounters with Medicare patients required that are to write prescriptions for durable medical equipment. Previously, nurse practitioners and clinical nurse specialists were required to certify that the order for durable medical equipment was based on a prior face-to-face visit with a Medicare patient as documented with a physician’s co-signature.
"This change improves access to services and will allow Medicare patients to receive equipment, such as portable oxygen systems and hospital beds, sooner," the American Nurses Association said in a statement.
Related:
Changing roles, changing rules in renal care
Rules on authority for nurses vary by state
The law, called the "Medicare Access and Children’s Health Insurance Program (CHIP) Reauthorization Act"also includes advanced practice registered nurses in the new Merit-Based Incentive Payment System. The incentive payment program replaces the Sustainable Growth Rate (SGR) payment formula.
“The provisions affecting nursing in this bill recognize that nurses provide high-quality, efficient and cost-effective services that are valued and needed by Medicare patients, many of whom rely on APRNs for their primary care needs,” said ANA President Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN. “Nurses are more than ready to meet the quality and accountability standards for reimbursement and will continue to improve the health care experience for some of the nation’s most vulnerable citizens.”
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Video: Renal program hopes to increase access to home dialysis - Edmonton Journal |
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Genes May Be Tied to Cardiac Arrest Risk in Dialysis Patients - U.S. News World Report |
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By Robert Preidt, HealthDay Reporter
THURSDAY, April 16, 2015 (HealthDay News) -- Genes may play a role in cardiac arrest risk among kidney patients who are on dialysis, new research suggests.
In a study of pairs of kidney patients who were on dialysis, the risk of cardiac arrest was 70 percent higher in the pairs where the two patients were blood relatives.
In general, patients on dialysis are 20 times more likely to suffer cardiac arrest than people in the general population, and cardiac arrest is the leading cause of death among patients on dialysis, the researchers noted.
The finding suggests that genes may play a role in cardiac arrest risk among these patients, and that pinpointing these genes may lead to new treatments to lower the risk, the researchers added.
The study was published online April 16 in the Journal of the American Society of Nephrology.
"These findings advance the science because they suggest that genetic factors -- or differences in DNA sequence -- contribute to the high risk of sudden death among patients on dialysis," study author Dr. Kevin Chan, from Massachusetts General Hospital in Boston, said in a journal news release.
"It paves the way for more detailed genetic studies in the dialysis population to find specific genes that could explain the high risk of cardiac arrest and potentially new treatments for these patients," he added.
The researchers analyzed data from nearly 650,000 dialysis patients, focusing on about 5,100 pairs of patients from the same family. Each patient was then matched to an unrelated control patient. Cardiac arrest was the cause of death in both patients in 4.3 percent of the family pairs, compared with 2.6 percent of unrelated pairs of patients.
Compared with unrelated pairs, the risk of dual cardiac arrest was 88 percent higher among genetically related family members who did not live together, and 66 percent higher among genetically related family members who did live together.
Dialysis patients who were spouses were not at increased risk for cardiac arrest.
More information
The National Kidney Foundation has more about dialysis.
Copyright © 2015 HealthDay. All rights reserved.
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Public Release: 16-Apr-2015 Family history increases the risk of cardiac ... - EurekAlert (press release) |
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Highlights
Among dialysis patients, genetically related family members have about a 70% increased risk of cardiac arrest compared with unrelated dialysis patients.
Spouses on dialysis do not have an increased risk.
Cardiac arrest is the #1 cause of death in patients on dialysis.Washington, DC (April 16, 2015) -- The increased risk of cardiac arrest experienced by patients with kidney failure may, in part, be inherited, according to a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN). Uncovering the genes that are involved may point to new treatments to protect patients' heart health.
Kidney failure patients on dialysis are 20-times more likely to experience cardiac arrest compared with individuals in the general population. To investigate whether inherited factors may play a role, Kevin Chan, MD MSc (Massachusetts General Hospital and Fresenius Medical Care North America) and his colleagues analyzed information on a population of 647,457 patients on chronic dialysis to identify 5117 pairs of patients who came from the same family. These patients were each matched to a control patient from the same population.
Among the major findings:
In 4.3% of family pairs, both members died of a cardiac arrest compared with 2.6% in the control pairs.
Genetically related family members who did not cohabitate had an 88% increased risk of dual cardiac arrest compared with their matched unrelated controls.
Genetically related family members who lived together in the same environment had 66% increased risk.
Spouses, who were genetically unrelated but lived together in the same environment did not have an increased risk.
"These findings advance the science because they suggest that genetic factors--or differences in DNA sequence--contribute to the high risk of sudden death among patients on dialysis," said Dr. Chan. "It paves the way for more detailed genetic studies in the dialysis population to find specific genes that could explain the high risk of cardiac arrest and potentially new treatments for these patients."###
Study co-authors include Christopher Newton-Cheh, MD, MPH, James Gusella, MD, MPH, and Franklin Maddux, MD.
Disclosures: KC and FWM receive salary support from Fresenius Medicare North America.
The article, entitled "Heritability of Risk for Sudden Cardiac Arrest in ESRD," will appear online at http://jasn.asnjournals.org/ on April 16, 2015.
The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.
Founded in 1966, and with more than 15,000 members, the American Society of Nephrology (ASN) leads the fight against kidney disease by educating health professionals, sharing new knowledge, advancing research, and advocating the highest quality care for patients.
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