Trump administration pushes U.S. at-home kidney care, transplant availability

Darnell Taylor
July 11, 2019

"For patients with kidney diseases across America, today's executive order represented a game changer". The president is delivering the speech at the Ronald Reagan Building and International Trade Center in D.C. It will also seek to shorten the time it takes for transplant candidates to receive kidneys from transplant centers.

Specifically, Mr. Trump is directing the government to revamp the nation's care for kidney disease, so that more people whose kidneys fail have a chance at early transplants and home dialysis - along with better prevention so patients don't get that sick to begin with. Currently, Medicare spends $35 billion on kidney failure and $114 billion annually on all kidney diseases-not including VA, Indian Health Services, and private insurers.

The changes won't happen overnight - some of the initiatives will require new government regulations. These individuals participated in prior meetings with Secretary of Health and Human Services Alex Azar and CMS Innovation Chief Adam Boehler to discuss reshaping the future of kidney care.

The Trump administration on Wednesday set goals to move more kidney disease treatment into patients' homes and increase transplants while reducing the USA reliance on more costly dialysis clinics. 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. "We look forward to continuing to work with nephrologists to help create even better care models for our unique population of patients".

"People who have kidney disease don't get diagnosed and treated fast enough because if we can get to people who are suffering from kidney disease early enough, we can slow down that disease progression and we can get them in the pipeline to get a transplant rather than going on dialysis", he added. The model should broaden the range of care and Medicare payment options available to potential participants with a focus on delaying or preventing the onset of kidney failure, preventing unnecessary hospitalizations, and increasing the rate of transplants.

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"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.

Too often, transplant centers don't see a kidney patient until he or she has been on dialysis for years, Tevar said. Last year, there were 21,167 kidney transplants.

Home options include portable blood-cleansing machines, or what's called peritoneal dialysis that works through an abdominal tube, usually while patients are sleeping.

Organs. (a) Within 90 days of the date of this order, the Secretary shall propose a regulation to enhance the procurement and utilization of organs available through deceased donation by revising Organ Procurement Organization (OPO) rules and evaluation metrics to establish more transparent, reliable, and enforceable objective metrics for evaluating an OPO's performance. But donors are out of work for weeks recuperating, and one study found more than one-third of living kidney donors reported lost wages, a median of $2,712, in the year following donation. Unlike the medical advances in transplantation, "we haven't really made big dents and progress and moves in increasing cadaveric organs or increasing live donor options".

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