Trump signs executive order to improve kidney care

Trump directing government to shake up care for kidney disease

President Trump's executive order aims to reform the nation's organ transplant and kidney dialysis systems and includes proposals to improve the performance of organ procurement organizations, incentivize living kidney and liver donation, ensure patients with kidney disease receive the best dialysis care available at an affordable cost, and increase the number of available organs for transplantation.

"Through new payment models and many other actions under this initiative, the Trump Administration will transform this situation and deliver Americans better kidney health, more kidney treatment options, and more transplants", he said.

Medicare's current payment structure pushes patients into in-clinic dialysis as a default option, often providing a significant burden to the lives of end stage renal disease (ESRD) patients. According to CMS, the payment adjustments would offer incentives to work with beneficiaries and caregivers in choosing ESRD treatment setting and support greater utilization of home dialysis and kidney transplants. Health and Human Services Secretary Alex Azar said Wednesday that transplants are the "end game" for kidney patients, noting that half of patients on dialysis die within five years.

President Trump's executive order lays out new payment models in Medicare and Medicaid for renal disease treatments that are meant to allow flexibility in how care is delivered based on patient's individual needs.

Other initiatives will require new regulations, expected to be proposed later this year.

A few also defended the former television personality, pointing out that he was probably using "special place in the heart" to emphasise on the importance of kidneys - rather than commenting on their physical location.

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Beneficiaries themselves would not see a change in their Medicare cost-sharing and keep existing protections under the new value-based system. The CKCC Models-Graduated, Professional, and Global-would utilize capitated payments similar to those used under the KCF Model, but the participating providers and facilities would be responsible for the total cost and quality of care for patients, and in exchange, could receive a portion of their Medicare savings.

"What President Trump is committed to doing is delivering the affordability that people need, the control that people want, and the quality they deserve in health care", he said. Additionally bonuses will be given out for every patient who receives a kidney transplant and remains healthy for three years.

Medicare payment changes that would provide a financial incentive for doctors and clinics to help kidney patients stave off end-stage disease. Azar believes the executive order will save money in the long run.

Since 1966, ASN has been leading the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

"The team behind this proposal has done something that will literally save tens of thousands or hundreds of thousands of lives, if not more", Okezie said. In addition, more needs to be done to address shortages in home dialysis supplies and any steps taken to encourage increased dialysis supplies would also be welcomed. "There are cases where they have to be there immediately, they have a certain period of time...we are going to make it so that it gets there in time".

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

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