President Trump is directing the government to overhaul 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.
“Right now every financial incentive is toward dialysis and not toward transplantation and long-term survivorship,” Health and Human Services Secretary Alex Azar, whose father experienced traditional and at-home dialysis before getting a living donor transplant, told a Senate hearing in March. “And you get what you pay for.”
Careful treatment — including control of diabetes and high blood pressure, the two main culprits — can help prevent further kidney deterioration. But more than 700,000 people have end-stage renal disease, meaning their kidneys have failed, and require either a transplant or dialysis to survive. Only about a third received specialized kidney care before they got so sick.
Too often, transplant centers don’t see a kidney patient until they’ve been on dialysis for years, he said. And while any transplant is preferable, one from a living donor is best because those organs “work better, longer and faster,” Tevar said.Medicare payment changes that would provide a financial incentive for doctors and clinics to help kidney patients stave off end-stage disease by about six months.
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