Dec 2, 2013 — A downside of this rule is that the total cut is still about 9% from today’s rate, but it will be phased in over 3-4 years.NKF is hopeful that the phased-in approach to dialysis payment cuts minimizes any immediate, negative impact on patients’ access to quality care. We still have many long-term concerns with this payment system. Specific areas of concern include overcrowded facilities due to possible closures and consolidations, and over-burdened staff due to hiring freezes that reduce patients’ ability to access much-needed expert services such as nutritional counseling and social work. Additionally, cuts may result in providers offering fewer convenient treatment times due to consolidation. This may also hinder access to longer treatment times, which improves patient outcomes according to recent research.