Evidence map›Paper›PMID 34051309›Full record

ArticleAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2021

Funding Innovative Dialysis Technology in the United States: Home Dialysis and the ESRD Transitional Add-on Payment for New and Innovative Equipment and Supplies (TPNIES).

Yuvaram N V Reddy, Mallika L Mendu, Eric D Weinhandl

Abstract read
In one paragraph

Article in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Bundle Fix?: We Need an Act of Congress.Journal of the American Society of Nephrology : JASN · 2025
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Yuvaram N V ReddyNephrology Division, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts. Electronic address: yreddy@partners.org.
Mallika L MenduNephrology Division, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
Eric D WeinhandlChronic Disease Research Group, Hennepin Healthcare Research Institute, Minneapolis, Minnesota; Department of Pharmaceutical Care and Health Systems, University of Minnesota, Minneapolis, Minnesota.

Funding

Novel Methods to Inform Health Care Policy in Home DialysisF32DK126345 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI REDDY, YUVARAM NELLORE VILAMBI · 2020 to 2020
$64k
NIDDK NIH HHS F32 DK126345
6 · The paper itself

Abstract

Innovative, patient-centered, and pragmatic dialysis technologies are urgently needed to accommodate the growing national interest in home dialysis use. To help achieve this goal, the US Centers for Medicare & Medicaid Services (CMS) are expanding reimbursement for eligible home dialysis machines through an existing payment mechanism, the transitional add-on payment for new and innovative equipment and supplies (TPNIES). This mechanism incentivizes the early adoption of innovative equipment into practice by reimbursing dialysis providers up to 26% of the total cost of approved home dialysis machines. Machines are evaluated for TPNIES eligibility using prespecified substantial clinical improvement (SCI) criteria that are derived from the Inpatient Prospective Payment System (for non-nephrology technologies). Although the SCI criteria may be suitable for some non-nephrology technologies, they have not been adapted to consider the unique and complex care inherent in home dialysis. Thus, many of the SCI criteria appear unsuitable for home dialysis machines. To better incentivize innovation, CMS should develop nephrology-specific transparent and pragmatic criteria for TPNIES. In this perspective, we provide an overview of the TPNIES payment mechanism, highlight areas of concern within the policy, and offer solutions for improving TPNIES that could better promote the adoption of new home dialysis machines.

Indexed as

Kidney Failure, ChronicProspective Payment SystemAgedHemodialysis, HomeHumansMedicareRenal DialysisTechnologyUnited StatesAdd-on paymentCenters for Medicare & Medicaid Services (CMS)dialysis modalityend-stage renal disease (ESRD)health care costhealth care innovationhome dialysismedical equipmentpatient-centered carepolicysubstantial clinical improvement criteriaTPNIES

Identifiers

PMID34051309
PMCPMC8608674

What OpenQuestion holds

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LicenceTDM
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.