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19 % reported receiving assistance from the American Kidney Fund and 23 % were enrolled in Medicaid . Access to Oral Medications Eighty-four percent of patients are prescribed an oral medication . Asked if they were unable , within the past 12 months , to obtain a prescription medication a doctor believed necessary ,
18 % of ESRD patients reported difficulty . The comparable percentage for the general public is 3 %. The disparity may be related to the greater health care needs of dialysis patients , and to doctor-prescribed nutritional supplements that are not covered by Medicare Part D . Satisfaction with Insurance Coverage The DPC survey finds that most ESRD patients ’ preferences for insurance type match with their current coverage . However , a significant portion of patients would like to be able to choose another type of coverage . While 74 % of respondents have Original ( fee-for-service ) Medicare as their primary insurance , only 47 % say that Original Medicare is their preferred choice . 25 % of ESRD Medicare beneficiaries would prefer private options such as ACA coverage or employer coverage . 5 % would like to enroll in Medicare Advantage . Not surprisingly , patient views about Medicare and private insurance differ according to whether the patient ’ s state guarantees access to Medigap coverage . Patients in states where Medigap is available to Medicare beneficiaries under 65 are more likely to express satisfaction with their Medicare coverage . Meanwhile , in the 25 states where Medigap is not available , patients are 50 % more likely to express satisfaction with their commercial coverage , and more likely to desire the ability to enroll in Medicare Advantage . We asked several questions from the Consumer Assessment of Health Plan Survey ( CAHPS ) to gauge patients ’ relative satisfaction with their coverage , which found that patients with commercial health insurance are more satisfied with their coverage than those enrolled in Medicare or Medicaid :
• A greater proportion of commercially insured dialysis patients rate their health insurance as the “ best health insurance plan possible ” than do those enrolled in Medicare .
• Medicare beneficiaries are more than twice as likely as private health plan members to report having trouble getting health care that they wanted or needed .
• Medicare beneficiaries are more likely than private health plan members to report difficulties in getting the specific medication they need , difficulty getting someone on the phone to answer questions , and delays in receiving care or treatment .
Home Modalities Our surveys find that while about 74 % of ESRD patients are informed about the option of home modalities , only 26 % seriously consider it . For those within the 46 percent gap of patients who were informed but did not consider it , the most frequently cited ( 45 %) reason for not considering it was the feeling of safety in a professionally-staffed clinic . But 37 % of patients reported that they could not consider home hemodialysis because they had no one to help them . Many in-center dialysis patients — about 72 %— say they have made up their minds to continue receiving treatment at the clinic . But 20 % say they would be willing to dialyze at home if they had a care partner . Among survey respondents who previously dialyzed at home but now receive treatment in-center , 18 percent stopped home dialysis because of care partner issues . There is a gap in information given to ESRD patients about home dialysis related to their type of insurance coverage . For home hemodialysis there is an information gap of 17 percentage points between patients covered by Medicare ( 77 %) and Medicaid ( 60 %). While 68 % of ESRD patients overall are informed about peritoneal dialysis , the information gap is 14 percentage points between patients covered by Medicare ( 70 %) and Medicaid ( 56 %). And while 72 % of ESRD patients overall are informed about transplantation , there is a 12 percentage-point information gap between patients covered by Medicare ( 76 %) and Medicaid ( 64 %).
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