Only about 8% of kidney patients do dialysis at home. Many don't know they can. Others are afraid to try it. And a limited number of places around the country offer training and support for home dialysis. New Medicare payment rules that just went into effect could change that. The changes give dialysis clinics more motivation to control costs and raise the amount centers get to teach do-it-yourself dialysis. Leslie Spry, MD, of the National Kidney Foundation says, once patients "experience the difference between home and in-center dialysis most will not return to in-center treatment."