
Administration Offers Progress Report on Kidney Care Initiative
An HHS report outlines efforts to reduce kidney failure and increase options such as home-based dialysis. COVID-19 has made kidney care a higher priority.
HHS on Monday offered a
The report came with a
Focusing on patients with end-stage renal disease (ESRD) is both a quality of life and cost issue for HHS, as fee-for-service Medicare spent $114 billion on kidney care, or $1 in every $5 the program spends. In its progress report, HHS outlined awareness campaigns, steps to promote value-based care, including new payment models; increased enrollment in the National Diabetes Prevention Program, and evidence that kidney failure from diabetes may be dropping among high-risk groups, including Native Americans and Alaskan Natives.
But the effort to improve care coordination has been criticized by some
COVID-19 has only increased the need for reform, according to a foreword to the report by HHS Secretary Alex Azar, because patients receiving dialysis are at higher risk for infection. At the same time, those who contract the virus are more likely to develop acute kidney injury, even if they have no history of renal problems.
“The risk of COVID-19 infection among Medicare ESRD beneficiaries is 3.5 times greater compared to all Medicare fee-for-service beneficiaries,” Azar wrote, citing a department claims analysis. “Moreover, the joint risk of COVID-19 infection and death is 5.2 times higher among Medicare ESRD beneficiaries compared to all Medicare fee-for-service beneficiaries.”
President Donald J. Trump launched the initiative last year with an executive order, and Azar laid out
- Reduce the number of Americans with ESRD by 25% by 2030
- Have 80% of new ESRD patients using at-home dialysis or receiving a transplant by 2025
- Double the number of kidneys available for transplant by 2030
Monday’s report featured examples of progress toward each goal, ranging from research initiatives within the National Institutes of Health (NIH) to efforts to protect civil rights of dialysis patients and end discrimination in allocation of kidneys available for transplant. A
- Release of a proposed
ESRD Treatment Choices Model , to boost rates for home dialysis and kidney transplant - Release of a proposal to expand what expenses can be reimbursed to living organ donors, to cover costs such as lost wages or child care
- Support for the KidneyX initiative, a partnership with the American Society of Nephrology to develop new treatments for kidney disease, including artificial kidneys and wearable dialysis machines
Efforts also call for screening more Black and Hispanic patients who may be at risk for ESRD, and to promote the availability of donor kidneys for these groups.
CMS covered new
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