Credit: Original article published here.Sodium-glucose transport protein 2 (SGLT2) inhibitors (SGLT2i), or gliflozins, block SGLT2 cotransporters in the proximal tubules and reduce renal glucose and sodium reabsorption.1 Reduced reabsorption of sodium results in natriuresis, which, through tubuloglomerular feedback, causes a reduction of intraglomerular pressure. SGLT2i have been shown to not only slow kidney progression in patients with chronic kidney disease regardless of diabetes status, but also improve glucose control, reduce the risk of heart failure, and reduce blood pressure, and they do so in a cost-effective manner.2 The use of SGLT2i has been limited despite approval in the United States since 2013 (canagliflozin). One important factor, which research suggests might be a myth, is that underutilization of SGLT2i therapy is due to their high cost or high copayments. Two recent studies have reported on utilization of SGLT2i where cost was not a factor, namely the US Department of Veterans Affairs (VA), where prescriptions are free. The first study by Mahtta et al looked at SGLT2i use in 537,980 patients with atherosclerotic cardiovascular disease (ASCVD) and type 2 diabetes mellitus (T2DM) in 130 VA facilities.3 They reported that approximately 11% of patients were on SGLT2i therapy. Surprisingly, among individuals with an

Credit: Original article published here.From the Field You read that right. The Medicare cost report that dialysis facilities submit each year can be an opportunity to capture revenue for certain bad debts. At a time when costs to run a dialysis facility are outpacing revenue, maximizing every available revenue source is more important than ever. With that in mind, I thought it would be helpful to provide some basic information about the dialysis facility cost report for those who are new to the renal industry or newly responsible for their facility’s Medicare cost report. The current form used to submit a cost report for freestanding dialysis facilities is the CMS-265-11. The Centers for Medicare & Medicaid Services (CMS) uses the cost report to gather data on treatment counts across all modalities, medication and supply utilization, costs to provide treatment and run the dialysis facility, as well as revenue and uncollected bad debt. If you are a dialysis facility administrator, you are likely familiar with collecting this information each year to pass on to whomever prepares your cost report. Filing a cost report could be likened to filing taxes; both are complex, can have serious financial and legal implications if done