The U.S. Department of Health and Human Services (HHS), through the office of the Assistant Secretary for Planning and Evaluation (ASPE), this week released a report describing the progress made over the past year since President Donald Trump signed an Executive Order launching the Advancing American Kidney Health initiative.
This initiative set forth specific action steps to transform kidney care by focusing on three goals: fewer patients developing kidney failure, fewer Americans receiving dialysis in dialysis centers, and more kidneys available for transplant.
“In the last year, we have seen more change and progress in kidney policy than we saw in the past several decades,” said HHS Secretary Alex Azar. “Through the President’s kidney health initiative, HHS team members, researchers, advocates, and patients are taking action to deliver Americans better kidney health in the years to come.”
As the nation confronts COVID-19, the pandemic further underscores the importance of the Department’s efforts to address kidney health as illustrated in this progress report. People with kidney disease and transplant recipients are at a higher risk for developing serious complications from COVID-19.
In addition, COVID-19 infection can cause acute kidney injury in some people, even in those who did not have kidney problems before they became infected with the virus.
Based on analysis performed by ASPE, using early Medicare claims data, the risk of COVID-19 infection among Medicare ESRD beneficiaries is 3.5 times greater compared to all Medicare fee-for-service beneficiaries.
In response to the President’s Executive Order on Kidney Health, HHS has continued to engage with stakeholders in their collaborative efforts to increase public awareness about kidney health, support and empower patients living with kidney disease, introduce new payment models for kidney care, and invest in innovative research and development. Key examples include:
- Supporting public outreach and awareness activities to increase knowledge of chronic kidney disease and its complications and how to control risk factors
- Launching new kidney care payment models to provide incentives for participating providers managing the care of patients with late-stage chronic kidney disease and patients with ESRD, to promote high quality care for people with kidney disease and transplant recipients
- Releasing a proposed rule to establish the ESRD Treatment Choices Model, designed to increase rates of home dialysis and transplantation by adjusting payment incentives for managing clinicians and ESRD facilities
- Releasing a proposed rule to revise the current Organ Procurement Organizations Conditions for Coverage to increase organ donation and transplantation rates by replacing the current measures with new transparent, reliable, and objective measures
- Releasing a proposed rule to expand the scope of reimbursable expenses for living organ donors to include lost wages, child care, and eldercare expenses to help remove financial barriers to organ donation; and publishing proposed changes to increase the household income eligibility threshold for living donors and organ recipients
- Continuing to support the KidneyX initiative, an HHS partnership through its Chief Technology Office with the American Society of Nephrology, to promote innovation in developing therapies for people living with kidney diseases and innovative approaches to detect infection, and design wearable dialysis machines and implantable bio-artificial kidneys
- Clarifying how innovative therapies may qualify for expedited regulatory approval and payment pathways
- The Office for Civil Rights has worked with states to ensure that state crisis standards of care plans do not discriminate against people living with kidney disease from receiving life-saving care when resources are in short supply
Additional activities and recent accomplishments by HHS components including the Assistant Secretary for Preparedness and Response (ASPR), Centers for Disease Control and Prevention (CDC), Centers for Medicare & Medicaid Services (CMS), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Indian Health Service (IHS), National Institutes of Health (NIH), and Office for Civil Rights (OCR) are described in Advancing American Kidney Health: 2020 Progress Report at: https://aspe.hhs.gov/pdf-report/advancing-american-kidney-health-2020-progress-report.
About 37 million American adults have chronic kidney disease, and more than 746,000 have end-stage renal disease (ESRD). There are nearly 95,000 Americans on the waiting list to receive a kidney transplant, and kidney disease ranks as the ninth leading cause of death in America.
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