HHS Proposed Changes to Care Delivery for Patients with Chronic Kidney Disease

PUBLISHED: Jul 12, 2019
Relevant to: Ambulatory Care, Critical Access Hospitals, Dialysis Facilities, Home Health, Hospice, Hospitals, Long Term Care, Medical Office

As directed by Presidential Executive Order, the U.S. Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services (CMS), through its Center for Medicare and Medicaid Innovation (CMMI), released a proposed required payment model and four optional payment models to adjust payment incentives to encourage preventative kidney care, home dialysis, and kidney transplants. The Department’s Assistant Secretary for Planning and Evaluation (ASPE) also released a paper entitled Advancing American Kidney Health, which lays out a number of areas for action, including measures called for in the Executive Order, for various components of HHS to improve kidney care.

In addition to proposed changes payment models for kidney care, the Executive Order also calls for HHS to:

  • Launch a public awareness campaign to increase knowledge of chronic kidney disease, which 40 percent of American patients do not know they have
  • Reform the organ procurement and management system in the United States to significantly increase the supply of transplantable kidneys
  • Expand support for living donors through compensation for costs such as lost wages and childcare expenses
  • Encourage development of wearable or implantable artificial kidneys, through cooperation between developers and the Food and Drug Administration (FDA) and support for KidneyX, a public-private partnership between HHS and the American Society of Nephrology

In addition, as described in in the ASPE paper, Advancing American Kidney Health, HHS will also, among other measures:

  • Improve Centers for Disease Control and Prevention (CDC) work on tracking and detecting chronic kidney disease throughout the population and supporting state and local efforts to develop a public health response for people with key risk factors.
  • Expand work to study and implement evidence-based approaches to preventing kidney disease through CDC and the National Institutes of Health.
  • Support work on portable dialysis options through the Assistant Secretary for Preparedness and Response to ensure individuals who need dialysis have ready access to treatment in the aftermath of disaster situations.
  • Inform development of new kidney disease treatments that align with patient preferences, including alternatives to dialysis, through patient surveys being developed by the FDA.
  • Examine ways to improve CMS’s ESRD payment policies.
  • Continue research work through NIH to advance precision medicine for kidney disease.
  • Launch additional prize competitions through KidneyX to support the development of new tools for preventing, managing, and treating kidney disease.
  • Work further toward reducing disparities in performance among Organ Procurement Organizations (OPOs) and transplant centers with the goal of increasing recovery of kidneys by OPOs and utilization of kidneys by transplant centers.

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