The dialysis industry has also flourished. DaVita and Fresenius in particular have grown quickly, buying smaller chains, consolidating their market share and locking in profits. The Kidney Fund says it got 78 percent of its revenue in 2015 from two companies, which insurers, state regulators and others identified as DaVita and Fresenius. Source“There’s a long history of recognition of the unique needs of that patient population,” said Philipp Stephanus, a senior vice president at DaVita who handles patient support and insurance issues. The Kidney Fund, DaVita and Fresenius said the federal agreement prohibited them from disclosing what percentage of applications the fund approved from those companies’ clinics, or how much the charity paid in insurance aid for patients at those clinics. But the 1997 deal tried to prevent any preferential treatment, no matter how big the companies became. Kevin McAnaney, a former government lawyer who helped draft the original agreement, said fairness to patients was at the heart of the deal. Everyone understood that “they were covering free riders who weren’t contributing anything,” said Mr. McAnaney, a lawyer in private practice who previously worked at the Office of Inspector General.
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Compared with a few decades additional info ago, families of children with chronic conditions perform many more medical tasks at home, from maintaining and operating feeding and breathing equipment to administering physical therapy. Home care is becoming more complex as more children with chronic conditions survive and as hospital stays shorten. The National Survey of Children with Special Health Care Needs (NS-CSHCN), a telephone-based survey, has estimated that 20 percent of households with children have at least one child with special health care needs. “If parents did not provide this care at home, children would need to stay in the hospital longer, professionals would need to come to the home, or children might not get the care that their physicians prescribe,” says Mark Schuster, MD, PhD, chief of General Pediatrics at Boston Children’s Hospital and senior investigator on the study. “Parents want to do everything they can for their children, but it can be a real challenge to juggle their ill child, their other children and sometimes their job.” Valuing home caregivers The new study analyzed data from the 2009-2010 Survey, and found that the average child with special health care needs received 5.1 hours of medical care per week from family members, a total of 1.5 billion hours nationally. This Thank You excluded any extra time spent assisting children with activities of daily living. For some conditions, the average was much higher: cerebral palsy: 14.4 hours per week muscular dystrophy: 13.8 hours per week cystic fibrosis: 12.9 hours per week intellectual disability 11.2 hours per week traumatic brain injury/concussion: 11.9 hours per week Nearly 12 percent of children in the study received 21 or more hours of family-provided care per week. These children were more likely to be poor or Hispanic or to be under the age of 5. Lost wages and replacement costs Family caregivers forego an estimated $3,200 in earnings per child each year, amounting to $17.6 billion most valuable in lost income nationally, the study found. Hiring health aides to do the same work at typical compensation rates would have cost an estimated $6,400 annually per child, or $35.7 billion nationwide.
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