Kidney Watch 2017

Kidney Watch 2017

Leaving ASN Kidney Week 2016, I was excited to integrate new knowledge and thoughts into processes to improve the care and outcomes of patients with advanced CKD.

After several years of declining interest, the future of nephrology as a career choice continues to be uncertain. Preliminary results from the Nephrology Match AY 2017 revealed a continuing trend toward unfilled nephrology tracks, with almost no change from AY 2016 (95 vs. 93 filled tracks). Programs may face the difficult choice of trying to recruit post-match or perhaps reducing program size and recruiting either more attending nephrologists or physician extenders including physician assistants or nurse practitioners.

We cannot discuss too much or focus in too much detail on the issues when it comes to the historic transition of power and influence post-election. Much has been said about radically changing the government, and health care has been in the crosshairs throughout the election and in planning for transition. Governance and policy will be all important in 2017. Although there is limited detailed conversation about how change will occur, there surely will be new policy and rules.

The likely repeal of the Affordable Care Act (ACA) early in the Trump administration has placed patients who gained coverage through the legislation and the ACA’s value-based kidney care initiatives in limbo.

The Trump administration and Republican leaders in Congress are vowing to quickly repeal the ACA when they take power in January 2017. The repeal is expected to allow a 2–3 year grace period for parts of the ACA to continue. After that time, Republicans are expected to replace the ACA with their own legislation.