Creation of payment models is a critical component of the Executive Order on the Advancing American Kidney Health (AAKH) initiative issued by President Donald J. Trump on July 10, 2019. At the time this article was written, the Innovation Center of the Centers for Medicare and Medicaid Services (CMS) had only released the End-Stage Renal Disease (ESRD) Treatment Choices (ETC) Model, a mandatory model that tests using payment policy to drive higher rates of home dialysis and kidney transplantation. The proposed payment policies will affect the managing clinicians and dialysis facilities assigned to the model. The four voluntary models to
On July 10, 2019, President Donald J. Trump and Health and Human Services (HHS) Secretary Alex M. Azar II unveiled a much-anticipated new HHS-wide kidney care initiative called Advancing American Kidney Health (AAKH). The initiative will bring sweeping changes to care for people with kidney diseases, including more focus on upstream treatment to slow the progression of kidney diseases, choices for dialysis modalities, greater access to transplantation, and concerted support for development of innovative therapies, including artificial kidneys.
The initiative was rolled out in a public signing of an Executive Order accompanied by a white paper
On May 22, 2019, the White House released its Unified Spring Agenda outlining the issues the administration will address through a proposed rule process in the coming months. The agenda highlighted administration priorities of improving the data used to evaluate Organ Procurement Organizations (OPOs) and removing financial barriers to living donation. Both policy priorities were discussed when ASN met with Department of Health and Human Services (HHS) Secretary Alex Azar and other senior administration officials in February to urge the department to address these issues.
The administration will address transplantation through two upcoming rules by:
After years of advocacy from the American Society of Nephrology (ASN) and other members of the kidney community, the Department of Health and Human Services (HHS) and members of Congress are expressing very similar viewpoints to those of ASN and the broader kidney community on some of the major issues confronting the 40 million men, women, and children facing kidney diseases in the United States.
In May 2019, both the administration and members of Congress demonstrated their commitment to change in two critical areas: immunosuppressive coverage and innovation in the kidney space. Building on a speech HHS Secretary Alex Azar
American Society of Nephrology (ASN) and the American Association of Kidney Patients (AAKP) partnered for the Seventh Annual Kidney Advocacy Day. ASN and AAKP representatives met with nearly 100 congressional offices to discuss KidneyX and request $25 million in funding for the program to run a series of prize competitions.
Owing to their efforts, and calls from other ASN and AAKP advocates, a bipartisan group of nearly 60 members of Congress wrote to the House Appropriations Labor, Health and Human Services, and Education Subcommittee asking them to include $25 million in funding for KidneyX in Fiscal Year (FY) 2020. The
After a sustained effort in support of National Institutes of Health (NIH) funding by the American Society of Nephrology (ASN) and the broader kidney community, Congress passed a $2 billion funding increase for NIH for fiscal year (FY) 2019. Additionally, the National Institute of Diabetes and Digestive Kidney Diseases (NIDDK) received a 5% increase that was widely celebrated by the kidney community.
Unfortunately, the gains seen by NIH and NIDDK have not translated into funding for the Division of Kidney, Urologic, & Hematologic Diseases (KUH), which saw a 2% decrease in total funding. NIDDK is a payline-driven funding program that
The year 2019 promises to be a busy one in healthcare. In the face of a great deal of volatility, Kidney News readers can expect the following.
Mergers and acquisitions: Expect more, and sooner rather than later
A recent Capital One survey found that three-quarters of 291 senior executives across the healthcare spectrum are planning for better business performance in 2019. To exceed 2018 performance levels, 44% support more mergers and acquisitions (M&A), and 25% also expect to revamp or update existing merger offerings already on the table. In the latest figures from 2018, the third quarter saw
In a fast-paced Kidney Week 2018 session titled “Reshaping Relationships and Transforming Care Delivery,” Janis M. Orlowski, MD, MACP, chief health care officer of the Association of American Medical Colleges (AAMC), captured the dynamic environment of healthcare in the United States when she led the session with “Consolidation: Friend or Foe?”—the Christopher R. Blagg, MD, Lectureship in Renal Disease and Public Policy.
Orlowski captured the situation with a comparison of the 2008 merger of Mercy Hospital of Pittsburgh, a 160-year-old institution with 428 beds, with the University of Pittsburgh Medical Center, compared with the recent signed letter of intent to
In November 2018, Medicare released the final Physician Fee Schedule (PFS) rule containing revisions to evaluation and management (E&M) code documentation requirements. Earlier, in a press conference announcing proposed E&M changes in July, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma said, “Evaluation and Management or E&M visits make up around 40% of all Medicare payments under the Physician Fee Schedule, and guidelines have not been updated since 1997—21 years ago,” adding that nearly 750,000 clinicians use these codes. “The requirements often mean that doctors have to cut or paste chunks of information across medical records strictly for
Fall in Washington, DC, during election years is typically known for being a slow time in the nation’s capital. For the kidney community, however, August and September of 2018 are proving to be anything but slow.
As the 2018 fiscal year for the federal government comes to a close on September 30, lawmakers are busy finalizing legislation to fund the government. In late August, the Senate passed a funding bill providing, among other provisions, the $2 billion increase for the National Institutes of Health (NIH) that ASN has been advocating for, and House lawmakers are rumored to be keeping the