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Health Equity

A history, a mission, a collaboration.

By Ben Williams, VP Business Development

Health Equity for End Stage Renal Disease (ESRD) patients was born from extreme challenges at the edge of technology, on the crossroads of social, economic and clinical decision trees. In 1961 a committee was formed to determine which patients should be chosen to receive new life sustaining dialysis treatments based on a list of weighted factors. [1] In 1972, the President changed the Social Security Act to give medical coverage to all patients diagnosed with Kidney failure. In 2019, the President signed a new executive order proclaiming the “state of care for patients with Chronic Kidney Disease (CKD) and ESRD is unacceptable” and provided an outline for policy updates. CKD has always been at the forefront of Health Equity with continuously evolving efforts to ensure that all citizens have access to treatment and a path to achieve their potential for health and well-being in spite of their disease state and regardless of their socio-economics status. Dialysis nurse and Rendevor founder, Donna Combs-Williamson, programmed health equity into the very DNA of our organization. As a result, Rendevor Dialysis has been caring for patients in the most complicated and challenging environments since the 90’s. Much like Large Dialysis Organizations (LDOs) formed during this same era, we have been emersed in a sea of shifting dynamics, on a voyage towards improving outcomes and increasing patient satisfaction. We remain committed to sustaining a course that aligns with our clients’ goals in Correctional, Acute, and Post-Acute healthcare environments.

Continuing this voyage in 2024, we endeavor to expand Renal Health Equity even further, collaborating with more SNF partners and bringing our passion for productive partnerships and patient care to more communities than ever. We, health care providers, have entered a new era in the merging of technology, equity and awareness. It is a renaissance on many fronts with advances that focus on improved Health span vs. Life span, the deployment of AI, gene editing and increased availability of home care opportunities. This is particularly meaningful for Dialysis Patients in need of Skilled Nursing and Post-Acute industry leaders are showing up to meet the challenge. Healthcare providers, payors and patients are realizing that ESRD patients residing in SNFs tend to be the most fragile and in critical need of the best our healthcare system can offer them.

Over the last decade, Dialysis in SNF or On-site Home Dialysis has consistently expanded into more locations with utilization of home dialysis increasing from 7.5% to 13.4% [2] Rendevor Texas Medical Director, Dr. Andrew Alpar, has seen it first-hand rounding on patients in Acute, Outpatient and Dialysis in SNF environments. Commenting recently on his observations over the last 30 years, “It is truly gratifying to enable quality dialysis care outside of a hospital to our patients who are recovering from illness and debility and who are not yet ready to go home or tolerate the rigors of repetitive transportation to outpatient facilities. This is a valuable service that will be welcomed by our patients and their families.”

We believe that moving forward, Dialysis in SNF will be the expected protocol for ESRD patients in need of Skilled Nursing or Long-term Care (LTC).  Dialysis in SNF allows for acceptance of sicker patients while frequently resulting in both earlier hospital discharge to SNF as well as faster SNF discharge to home. [3] At this unique intersection of equity, outcomes, and patient satisfaction, we can realize an unprecedented value alignment where patients, payors, and providers all win together.  As one of my healthcare mentors often says, “the whole of what we do is much larger than our individual parts”. The Rendevor Dialysis team is ready to do our individual part, to forge great partnerships; to collaborate daily with leaders in the Corrections, Acute and Post-Acute (SNF) environments and to contribute to the whole of improved access to Healthcare Equity. We thank our current partners for journeying with us and we look forward to forging many new partnerships over the next 30 years.

[1]  Alexander, Shana. Medical Miracle and a Moral Burden of a Small Committee. Life. November 1962

[2] U.S. Renal Data Systems. Chapter 2, Home Dialysis. USRDS Annual Report.  2023

[3] Eran Y Bellin, Hellebrand A, et al.  On-Site More Frequent Dialysis May Hasten Return Home for Nursing Home End-Stage Renal Disease Patients. Kidney 360. 2024