Aksys PHD

Some questions for past/current users of Aksys PHD:

  1. What were your total costs for machine installation (i.e plumbing/elec./water softener)?

  2. What is your monthly cost for water/elec.?

  3. How many weeks of training did you need to go home with machine?

It was three years ago for me…I’d have to go back and see. I think this would vary by location and provider. Heather what part of the country are you in - if you don’t mind me asking? Are there other home patients already doing daily?

North and there are no programs in our city.

-Heather you are looking at about $1500-2000 for the plumbing and electrical.

-About 4-8 weeks for training

-I heard peoples bills go up as much as $100-200 more a month.

Tucker,
Are you a patient or a family member? Where did you get these figures?

Hi Heather,
Aksys will give you the K/watt hours for the daily usage also the water consumption… I can’t put my hands on them right now…but we had a roomate before I went on Aksys so when I did we had to re-work everyone’s share and we had to know how much extra was needed to account for my Dx. The electric came to an extra $20. and the water was even less. I don’t know where those reports of $100-200 are coming from,
I live in the Pacific NorthWest, I don’t think the power and water is cheap here…
I will try and get the exact numbers of usage and local water and electric cost per…whatever and report back…don’t be too concerned it is very do-able. If it ‘hurt’ too much there would have been a revolt in my house.

oops oh yeah, I wasn’t finished.
The plumbing and electrical was all taken care of by the Dialysis Center…in the case of AKsys they had some deal with the center where they covered some or all of the cost…
I have moved 5x with Home Dialysis in the last 15 years and the plumbing and electrical was always covered by the Dialysis company.
I trained in 3 weeks on the Aksys… it’s pretty easy.
I’ve used for Home a Baxter, Cobe Century 2, 3, Fresenius 2008 H, K and the Aksys.
Most machines are not difficult to learn, they are just initially overwhelming especially to a helper who’s ‘burdoned with the grave responsibility’…fortunately my wife was not so ’ burdoned’ and knew that I was going to do it by myself anyway. 8)

If the plumbing and elec. is always taken care of by the dialysis center, is private insurance or Medicare paying for it?

How do you like the Aksys PHD as compared to all the other machines you were on? Is it much easier to learn and operate? Any differences with the quality of the tx? How long are your txs?

Glad to hear the energy costs are not excessive.

I don’t now how many dialysis centers pay the cost of plumbing and electrical modifications. I do know that I’ve talked with people at clinics that do not pay for home modifications. They may have contracts with people that do the work that keeps the cost down, but patients may have to pay the costs themselves. This is something to discuss with the dialysis clinic.

Before people get angry about clinics that don’t pay these costs, let me try to explain a few things about why some don’t.

  1. Medicare manuals are vague about what Medicare pays for so far as home modifications – described as “minor modifications” to hook machine into existing plumbing and electrical. This might rule out putting in a separate circuit for the dialysis machine (some clinics require this for certain machines). I’ve asked and have never gotten exact instructions on what plumbing is considered minor.

  2. There is a difference in how dialysis clinics and dialysis supply companies are paid by Medicare. Although most patients that do home dialysis are signed up with Medicare as Method I patients. It is possible that patients who don’t have to pay for home modifications may be signed up as Medicare Method II patients. Patients are supposedly the ones that make this “choice,” however, in reality typically the clinic advises the patient which option to choose.

Method I patients get everything through their dialysis clinic – training, machine, supplies, ongoing support, etc. The clinic bills Medicare. Medicare pays a set rate per treatment that is meant to cover everything. The clinic can charge only $20 extra for every training day (of which the clinic gets 80% or $16). This is for several hours of one-on-one nursing time.

Method II patients are trained by the clinic and get support from the clinic. Medicare pays the clinic a set amount for training ($20 plus the allowed dialysis charge) and up to a maximum amount for all the calls and visits that the patient makes to the clinic to any clinic staff. The doctor’s charge is extra. The Method II supplier is allowed to charge Medicare several hundred dollars a month more than a dialysis clinic can charge for providing the same services. Therefore it is possible that a supply company will absorb the cost of home modification because it is getting more for every treatment.

  1. Also, because the regulations are vague about home modification, some Medicare intermediaries (the insurance company that is the contracted payer of Medicare claims for dialysis in that state or region) may pay charges while others won’t. It would be nice if there was an “operational definition” that made payments more consistent. However, there is no guarantee that by seeking a more explicit definition that it would help more patients. There is a risk that it would just make those that are paying for this now not pay for it in the future.

Hope this helps to explain why things may be different from one clinic to another and one patient to another.

If the plumbing and elec. is always taken care of by the dialysis center, is private insurance or Medicare paying for it?

I did not pay nor was I billed. So no insurrance that I was responsible for or had records of paid or if they did I did not see the bills or records.
In the moves that I made in the last 15 years, I did not decide I want/ need to move to this city, I shopped Dialysis clinics for the best possible ‘setup’ that I could get and these people in most cases were ‘hungry’ to start an Home Program. Then I decided where to go based on that. The last time I moved I followed a very supportive Physician to the city where her husband’s job took him and she followed…so I went where I could get the most responsive and beneficial care … call me crazy but then many do…

How do you like the Aksys PHD as compared to all the other machines you were on? Is it much easier to learn and operate? Any differences with the quality of the tx? How long are your txs?

The Aksys is the best I’ve ever used. Yes, it is much easier to learn and operate. The Tx seem easier on me and a better quality although I have never done daily Dx on any of the other machines …at most every other day. My treatments are usually 2 hrs 6-7x week on the day after a day-off, I usually go 3 hrs as a catch-up. If and when mobility becomes more important to me, I would welcome the incredible advantage of the Nextstage.

Guillaume

Guillaume writes:
In the moves that I made in the last 15 years, I did not decide I want/ need to move to this city, I shopped Dialysis clinics for the best possible ‘setup’ that I could get and these people in most cases were ‘hungry’ to start an Home Program. Then I decided where to go based on that. The last time I moved I followed a very supportive Physician to the city where her husband’s job took him and she followed…so I went where I could get the most responsive and beneficial care … call me crazy but then many do…

This is certainly an interesting story. Having a great doc who is supportive of home programs is half the battle. How many times have you moved? What prompted you to keep moving if you were happy with your initial home program? Sounds like you have seen the country on dialysis. Not a bad idea : )

This is certainly an interesting story. Having a great doc who is supportive of home programs is half the battle. How many times have you moved? What prompted you to keep moving if you were happy with your initial home program? Sounds like you have seen the country on dialysis. Not a bad idea : )

About 4 or 5 times, depends how I count them.

When the spirit moves us, we move. It is easier to “MOVE” on dialysis than travel. Search Dialysis units in the US and you’ll see how many do not take transients, meaning traveling patients. I have sometimes forced myself on a unit when traveling, a wholey unpleasant affair for all.
Most Dialysis Centers that I have begun to train for home at, have tolerated me and are glad to get me ‘home’, and out of their hair. They believe I have a tendancy to bend rules past the breaking point, the way that i see it, of course is different.
Guillaume

I got these figures from the patients themselves. They where told the amount of $25-30 but in reality it has been $100-200. Also not every clinic will pay for your modifications, most likely none will, your better off checking with your insurance company.

Guillaume wrote:

The electric came to an extra $20. and the water was even less. I don’t know where those reports of $100-200 are coming from,
I live in the Pacific NorthWest, I don’t think the power and water is cheap here…

Tucker wrote:

I got these figures from the patients themselves. They where told the amount of $25-30 but in reality it has been $100-200.

Which is correct???

Only thing I can say is try to get more info from more Aksys patients over a longer period of time. This is just the information I heard from PHD users themselves. I know Aksys has had some complaints as well about the amount there users bills have gone up and where going to do some more research into it by trying to compare bills before and after PHD.

Tucker are you a patient? What patients are you talking to? What is your connection to home hemo?

I have talked to patients all over the country both PHD and NxStage. These are some of the concerns they tell me. I gather info and research to help them to live better and make the right choice when the dialyze.

I have talked to patients all over the country both PHD and NxStage. These are some of the concerns they tell me. I gather info and research to help them to live better and make the right choice when the dialyze.[/quote]

Tucker writes:

I have talked to patients all over the country both PHD and NxStage. These are some of the concerns they tell me. I gather info and research to help them to live better and make the right choice when the dialyze

Tucker writes

Only thing I can say is try to get more info from more Aksys patients over a longer period of time. This is just the information I heard from PHD users themselves. I know Aksys has had some complaints as well about the amount there users bills have gone up and where going to do some more research into it by trying to compare bills before and after PHD.

How do you get patient info. like this considering privacy rights? I am researching costs of PHD, and other than one person on this board, Guillaume, have not gotten any other reponses.

How did you get this info from PHD users?

So you’re a researcher? Who do you work for?