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Kidney Week

Abstract: TH-PO310

Characteristics of Tablo Home Hemodialysis Users in Medicare Fee-for-Service

Session Information

  • Home Dialysis - I
    November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Dunning, Stephan C., Outset Medical, San Jose, California, United States
  • Aragon, Michael A., Outset Medical, San Jose, California, United States
  • D'Alessandri-Silva, Cynthia J., Outset Medical, San Jose, California, United States
  • Weinhandl, Eric D., University of Minnesota Twin Cities, Minneapolis, Minnesota, United States
Background

The Tablo® Hemodialysis System was cleared for home hemodialysis (HHD) use in March 2020, offering dialysis patients the first novel technology for HHD since 2005. In the 2022 ESRD PPS Final Rule, the Centers for Medicare and Medicaid Services (CMS) designated Tablo a “substantial clinical improvement” over the incumbent technology based on increased treatment flexibility, higher treatment adherence, higher modality retention and improvement in patient quality of life. This designation made it eligible for Capital-Related Assets Transitional add-on Payment for Innovative Equipment and Supplies (CRA TPNIES).

Methods

Using CMS Medicare FFS Limited Data Sets, we identified Tablo HHD claims between Jan 1 and June 30, 2022, using HCPCS E1629, which was designated for billing the CRA TPNIES reimbursement. Importantly, TPNIES billing is not validated, so may under capture the true Tablo HHD population in Medicare FFS. We then summarized user characteristics, including age, sex, race/ethnicity, and concurrent Medicaid enrollment, as well as treatment characteristics.

Results

Between Jan 1 and June 30, 2022, there were 53 patients who collectively had 1,830 billed Tablo HHD treatments (Mean treatments per patient: 34.5, SD: 25.2). The mean (SD) age was 60.6 (15.5), with 51% age ≥65. Racial distribution was 28.3% Black, 49.1% White and 22.6% Other, and 34.4% of users had concurrent Medicaid enrollment. A summary of the billed treatments shows a mean (SD) weight of 82.9 (20.8) kg, and a mean (SD) hemoglobin of 9.8 (1.4) g/dL. Vascular access type in use was 42% Catheter, 58% Fistula. Based on billed Tablo HHD treatment volume, the total TPNIES add-on payments (assuming $25 per treatment) in the first half of 2022 are estimated to be $45,750.

Conclusion

This is a novel and early window into Tablo HHD users and treatments in the Medicare FFS population and a first estimate of the TPNIES add-on payment. Thus far, the population appears to be more elderly and diverse, and with greater catheter dependence than the broader HHD population. Additional research into Tablo HHD adoption, utilization and outcomes in the Medicare population will be important for understanding and advancing home dialysis growth overall.

Funding

  • Commercial Support – Outset Medical