The value of nonprofit dialysis in a for profit world

In my previous post I asked: Why not encourage dialysis provider consolidation? Another way to say this would be to ask: Is there value in nonprofit healthcare? The question of profit is infused in the current political debate as we struggle to reform the distorted US healthcare system. By way of addressing the larger question let me focus on a single dialysis provider. My dialysis provider who I consider the best US dialysis provider: the Northwest Kidney Centers.

What makes the nonprofit Northwest Kidney Centers the first out-of-hospital outpatient dialysis program in the world, founded in 1962, a valuable community asset in 2008? Here, adapted from the NKC Community Benefits Statement are my top 10 reasons (in no particular order) that the Northwest Kidney Centers brings value to our region and the world (even if we can't purchase EPO for $8.50):

1. We are an integral part of the region’s health care community, close and accountable to our “owners”--- the people of this region. We chose to be nonprofit in 1962 and remain so today.

   NKC FACT: NKC is the largest community-based nonprofit dialysis provider in the United States, the only one with an involved lay board of trustees, five regional councils, hundreds of volunteers, and an active philanthropic fundraising department led by a Foundation Board.  The NKC medical staff includes every nephrologist (kidney physician) in the region. 

2. We accommodate patients rather than ask patients to accommodate us. NKC has units open on both Saturday and Sunday to accommodate patient preferences.  NKC always operates units in the evening so dialysis patients can work, go to school, and tend to daytime activities.  Diabetes education is available for any patient who needs help, without charge.

   NKC FACT: NKC serves nearly 80% of the people in King County who require life saving dialysis therapy.  Over 200,000 dialysis treatments are provided every year in 12 centers and 10 hospitals in King and Clallam Counties and in 180 homes throughout Washington State.

3. More dialysis is better for health, so NKC will schedule patients for longer treatment times than average, without increased charges.

   NKC FACT: NKC's average treatment length is over 10% longer than the national average.
   

4. NKC provides the region’s Special Care Service, intensive dialysis care for people with complex medical, psychiatric and cognitive problems.

   NKC FACT: NKC's Special Care saves patients the personal trials of frequent trips to the hospital and avoids the expense of unneeded hospitalization.  Last year Special Care incurred over $2.2 million in unreimbursed dialysis costs and took care of over 200 desperately ill patients.  It is the largest single community service operated by NKC and may be the nation’s only out-of-hospital unit of its kind.
   

5. NKC has an international reputation, especially in home dialysis, as a leading resource for patient centered care. 

   NKC FACT: NKC's home dialysis programs are among the largest home dialysis programs in the world. NKC is regularly visited by professionals from around the globe, most recently those especially interested in our thriving daily home hemodialysis program.  NKC is featured in videos produced by home dialysis advocates.  NKC's willingness to share what we have learned is helping thousands of patients live independent lives despite serious kidney disease in regions far beyond the Northwest.
   

6. NKC operates the nation’s only outpatient pharmacy dedicated to kidney patients - those with transplants, on dialysis or with chronic kidney disease. 

   NKC FACT: Over 600 kidney patients a month utilize this service. The renal pharmacists are specialists who understand the complexity of the many medications taken by people with kidney failure and help patients avoid the dangerous risks of adverse drug interactions.
   

7. NKC clinical quality results outperform national results, with higher survival rates, better vascular access, excellent nutritional status and benchmark rehabilitation results.

   NKC FACT: Daily and home dialysis helps patients thrive, despite chronic illness.  More NKC patients are employed than reported by other programs in the Northwest; they are back to work as productive, tax-paying citizens.  The payers who fund dialysis- mostly Medicare but also Medicaid and commercial insurance- can rest assured that their investment is paying off.
   

8. NKC invests nearly $2.5 million/year (of its $75 million budget) in providing direct community benefits.

   NKC FACT: These community benefits include clinical research to improve the lives of those with CKD, training of nephrologists, educational scholarships for patients, charity care (including medications for transplant patients), emergency grants for patient crises, transportation assistance to patients, CKD and organ donation education for public and health professional, and unreimbursed services for people facing severe kidney disease. This region is vastly richer in knowledge and services because NKC is advancing kidney health.
   

9. NKC goes to the community, so the community wont have to go to us. Since 2003 NKC has hosted the annual Kidney Health Fest for African American Families with a focus on children and youth, last year attracting over 700 participants. In 2005, 2006 & 2007 NKC Produced the Family Health and Kidney Expo attracting nearly 4,000 people in its three years.  The NKC's Living Well with CKD™ Program offers Choices and Healthy Eating classes for hundreds of predialysis patients and their family members each year.  Our participation in over 60 outreach events a year, brings our awareness message to thousands of additional people.

   NKC FACT: All of these events and service are provided at no cost to the participants.  NKC works to inform our neighbors that our nation is experiencing an epidemic of silent, deadly kidney disease, which affects 1 in 9 adult Americans. The number of dialysis patients will double by 2015.  Kidney disease is common, harmful but treatable, and NKC is making sure those at highest risk know that we’re here to help slow kidney disease, avoid deadly complications, and stay off dialysis.

10. NKC's Trustee Board Chair is on dialysis and has had stage 5 CKD for 20 years.

    NKC FACT: People on dialysis and living with a transplant volunteer throughout the organization. They are well represented on the NKC Board of Trustees, on the NKC Foundation Trustee Board, on all board committees and on all NKC Regional Councils. NKC patients volunteer with national patient advocacy groups, for the renal network, for industry bodies and for the Center for Medicare and Medicaid Services.