Kidney disease is the ninth leading cause of death in the United States. Approximately 37 million Americans suffer from chronic kidney disease (CKD), and more than 726,000 of those have end-stage renal disease (ESRD). Of the more than 100,000 Americans who start dialysis annually, one in five are projected to die within a year, and nearly 100,000 more are on waiting lists to receive kidney transplants. 

To combat this situation, in July 2019 the U.S. Department of Health and Human Services (HHS) issued a press release announcing that the president had signed an executive order to launch Advancing American Kidney Health, an initiative to achieve the broad goals of:

• improving the lives of Americans living with kidney disease;
• expanding options for American CKD and ESRD patients; and
• reducing healthcare costs.* 

How will the U.S. government do this?

To achieve these goals, HHS has focused its efforts on the following measurable goals:

• In 2025: Have 80% of new ESRD patients either receive dialysis at home or undergo transplant.
• By 2030: Reduce the number of Americans who progress to ESRD by 25%. Double the number of kidneys available for transplant.

What about reducing healthcare costs?

The Centers for Medicare & Medicaid Services (CMS) are working to make kidney disease prevention, care, and treatment more affordable for both patients and payers. To that end, they have proposed four optional payment models and one required payment model that are all under consideration. 

What other changes and actions does the executive order call for?

As per the executive order, HHS is also working to:

• launch a public awareness campaign to increase knowledge of chronic kidney disease, since 40% of Americans living with the disease are unaware they have it;
• expand support for living donors through compensation for lost wages and child care expenses;
• boost work on portable dialysis options for use in the aftermath of disaster situations;
• encourage development of wearable or implantable artificial kidneys and other alternatives to dialysis; and
• enhance and regulate performance among organ procurement organizations (OPOs) and transplant centers, in order to significantly increase the number of available transplantable kidneys.

“Decades of paying for sickness and procedures in kidney care, rather than paying for health and outcomes, has produced less-than-satisfactory outcomes at tremendous cost,” said HHS Secretary Alex Azar. He added that the actions called for under the new initiative should “transform this situation and deliver Americans better kidney health, more kidney treatment options, and more transplants.”

For more information on the Advancing American Kidney Health initiative, visit the U.S. Department of Health and Human Services.

*U.S. Department of Health and Human Services. (2019, July 10). “HHS Launches President Trump’s ‘Advancing American Kidney Health’ Initiative.”