As a chronic kidney disease (CKD) patient, you may or may not be surprised that healthcare laws are not always patient-centered. While there still are many areas of opportunity, an executive order was signed by the president in 2019 to help improve care for CKD patients. Learn more about the order known as the “Advancing American Kidney Health Initiative” and how it may benefit you or a loved one.* 

An Attempt to Help Becomes a Problem 

In 1972, the National End-Stage Renal Disease (ESRD) Program was formed. It authorized Medicare entitlement for dialysis therapy coverage under Parts A and B of Medicare without the age requirement of 65 years and older. Additions to the program were made over the next two decades, including designated ESRD Network Organizations to act as the federal government’s “eyes and ears” to ensure quality care and safety for patients. 

Providers were financially incentivized to initiate dialysis, which led to significant growth of the dialysis industry. Moreover, in the late 1990s, medical organizations issued practice guidelines for earlier dialysis transition. In the last few years, however, the wisdom of that guideline change has been increasingly called into question. 

Delaying Dialysis May Be Better for Some

For many patients, dialysis therapy is taxing on the body. Delaying dialysis by using effective nutritional management along with additional drug therapy could be a more patient-centered approach, especially for the elderly. 

This more conservative approach was supported in July 2019 when the “Advancing American Kidney Health Initiative” was issued. It aimed to reduce ESRD rates by adding strong financial incentives for healthcare providers to better manage the care of patients with advanced CKD who are not on dialysis. As part of an interdisciplinary team of registered dietitians, social workers, pharmacists, and others, physicians may be able to delay disease progression and even perform preemptive kidney transplants. 

Going forward, as kidney care shifts to what’s being called a value-based care model, physicians and insurance carriers will continue working to better identify and provide affordable care for advanced CKD patients. If you are a CKD patient not on dialysis, speak with your physician and/or insurance provider about how you may be able to work with a team of healthcare experts to help preserve your kidney function through value-based care. 

*Kalantar-Zadeh, K.. (2022, April 8). Implications of Value-Based Models in Kidney Care. Renal and Urology News. https://www.renalandurologynews.com/home/conference-highlights/national-kidney-foundation-annual-meeting/implications-of-value-based-models-in-kidney-care/