Trump revamps kidney care to spur transplants, home dialysis

Trump directing government to shake up care for kidney disease

Surgeons work on a kidney during a 2016 transplant surgery at Med Star Georgetown University Hospital in Washington

- President Trump will announce changes to improve the care for people with kidney disease on Wednesday, July 10, at 11am.

The order will launch the Advancing American Kidney Health initiative, which aims to fight kidney disease using multiple approaches, including the speeding up of matching patients and donors for transplants, making home-dialysis a more common option, pushing development of artificial kidneys and improve costs for treatment.

"At CareDx, we believe transplantation is better than dialysis because it promises better quality of life for kidney patients, provides better outcomes and is demonstrably more cost effective for the healthcare system overall", said Peter Maag, CEO of CareDx. "And you get what you pay for".

"My health care providers failed me at the beginning of the dialysis continuum", said transplant recipient Tunisia Bullock of Rocky Mount, North Carolina.

"Many, many people are dying while they wait", he said. "What they do is so incredible". Around 100,000 Americans are waiting for a kidney transplant, and his executive order will help to streamline the kidney transplant process.

Ensuring 80% of new kidney failure patients in 2025 either are receiving dialysis at home or are receiving a transplant.

The executive order includes the introduction of five new payment demonstrations, including one that will compel providers to participate. The demonstrations will, among other things, create incentives for dialysis providers to offer the treatment in a patient's home.

The announcement comes amid reports that Trump will soon nominate Boehler to lead the Overseas Private Investment Corp., which drives private investment in developing economies.

The U.S. government spends $114 billion each year to treat chronic kidney disease and end-stage renal disease.

The dialysis market also remains highly concentrated, with just two major players - DaVita and Fresenius - dominating it.

The order will attempt to speed up the time it takes to match patients and donors for kidney transplants.

"The way the system is set up, it's kind of pushing people towards dialysis", Seema Verma, head of the Centres for Medicare and Medicaid Services, said in a phone interview.

Trump's speech expanded on a host of initiatives already underway within the administration. This initiative is his latest effort to improve care for patients living with ESRD while in office.

Almost 15% of the U.S. adult population was suffering from chronic kidney disease in 2018, fuelled by growing rates of diabetes and hypertension, according to the government's U.S. Renal Data System. The contest is expected to dole out a total of $2.6 million in prize money when it wraps in January 2020.

CMS is also proposing to increase a bonus payment for certain innovative technologies, which could include some treatments or devices stemming from the KidneyX competition. President Trump says if Obamacare is scrapped by the court, Republicans will have a plan to replace it but it could leave millions of Americans, especially those with preexisting conditions, with great uncertainty.

KCP is committed to respect the desires and interest of patients in selecting the modality they believe will work best for them, as well as working with the Administration to develop an appropriate path that will move us closer to the aspirational targets the President has referenced today.

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