Kidney Diet Tips


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CMS-Proposed Cuts to Dialysis Payment: The Impact on Nutrition Care for Dialysis Patients

If you are a renal dietitian, you have most likely heard about the Center for Medicare and Medicaid Services (CMS) proposal to cut payment for dialysis treatment by nearly 10 percent. I encourage you to join the other members of the kidney care community who are responding in protest and even outrage that such a cut is being considered. Medicare payments already fail to cover treatment costs adequately, and it’s well known that dialysis centers with mostly Medicare patients operate at a loss and would not be able to operate if further cuts are implemented.

I’ve worked in the kidney community for more than 20 years and have witnessed many changes that have helped improve care and quality of life for dialysis patients. Adequate resources from a strong, unified healthcare team—nurses, dietitians, social workers, technicians and physicians—improve patient outcomes and decrease hospitalizations and mortality. Engaging patients in their care and keeping them motivated to take medications, follow the challenging renal diet, keep appointments and more requires an adequately sourced team.

One of my concerns with the proposed Medicare cuts is the impact it can have on our patients by limiting resources at dialysis centers, including human resources. How could these cuts change the patient load for dietitians and other team members? Would we face slashes in employment hours to help facilities meet budget, at the expense of decreasing the level of care we provide to our patients?  Will we see unprofitable dialysis centers close and fewer new ones open to take care of the growing number of dialysis patients? How will it affect your patients if they are required to travel a longer distance when their neighborhood center is forced to close? Fewer operating hours means fewer evening shifts for working patients. Patient safety is also a concern. Personal safety while traveling to a center that’s farther from home is a concern. Meeting the CMS care requirements already stretches many kidney healthcare workers to capacity. The persons who are impacted most negatively are the most vulnerable—our current and future dialysis patients.

Please let your voice be heard in protest of the CMS-proposed cuts by taking the following actions:

  1. Go to to send a letter to Congress. Do it today—make sure your Congress members know that cutting nearly 10% from an essential program will hurt people who depend on dialysis to stay alive.
  2. Tell your coworkers, patients, physicians, family members and friends to do the same.
  3. Post messages on Facebook and Twitter. Simply copy and paste these sample posts on your social sites and encourage your friends and family to do the same:
    • Facebook: Friends and family: Help protect access to dialysis. More than 80% of dialysis patients rely on Medicare for their care. Tell Congress to stop Medicare cuts before they start. We need your help:
    • Twitter: Help protect access to dialysis. Tell Congress to stop Medicare cuts before they start. We need your help:

One voice can make a difference that will affect hundreds of thousands of lives. If we all cry out together, CMS cannot ignore our message.

Sara Colman, RDN, CDCES

Sara Colman, RDN, CDCES

Sara is a renal dietitian with over 30 years experience working with people with diabetes and kidney disease. She is co-author of the popular kidney cookbook "Cooking for David: A Culinary Dialysis Cookbook". Sara is the Manager of Kidney Care Nutrition for DaVita. She analyzes recipes and creates content, resources and tools for the kidney community. In her spare time Sara loves to spend time with her young grandson, including fun times together in her kitchen.