The Department of Health and Human Services (HHS) recently launched an initiative to address increasing concerns about the public health impact of the growing number of Americans with multiple chronic conditions.
Approximately 75 million Americans have multiple chronic conditions, including kidney disease, heart disease, and diabetes. Nearly 30 million Americans—13 percent of the population—have chronic kidney disease (CKD). CKD is a common co-morbid condition among patients with other chronic conditions, particularly hypertension, cardiovascular disease, congestive heart failure, diabetes, and peripheral vascular disease. As a patient’s number of chronic conditions increases, so too does his or her risk of unnecessary hospitalizations, duplicate tests, conflicting medical advice, and mortality. Today, 66 percent of all health care spending is directed toward care for the approximately 27 percent of Americans with multiple chronic conditions, according to HHS (Figure 1). Medicare spends $42 billion annually to treat people with CKD alone—yet it remains the ninth leading cause of death (1,2).
Percentage of Americans with multiple chronic conditions versus total spending on multiple chronic conditions.
Citation: Kidney News 2, 8
Given the increasing costs of, poor outcomes among, and complexity of managing care for people with multiple chronic conditions—and the leading role HHS plays in health research and payment for and delivery of health care services—HHS recently organized a workgroup on individuals with multiple chronic conditions. This workgroup, which included representatives from nearly every HHS operating division, drafted a “Strategic Framework on Multiple Chronic Conditions (MCC).” Intended to help the department prevent and improve quality of life for individuals with multiple chronic conditions, the draft framework identified opportunities for HHS to take a more coordinated, comprehensive approach to care internally and in collaboration with external stakeholders.
Responding to HHS’ request for public feedback on the draft framework, ASN President Sharon Anderson, MD, FASN, submitted a comment letter on behalf of the society, drafted in conjunction with the Public Policy Board and ASN staff. In its comments, the society applauded HHS’s initiative of improving the health and quality of life for individuals with concurrent chronic conditions, but emphasized the importance of including kidney disease. The initial draft did not include mention of CKD or end stage renal disease.
The ASN Public Policy Board looks forward to collaborating with HHS in its efforts to improve outcomes for patients with multiple chronic conditions—including kidney disease—and will continue to advocate for recognition and inclusion of kidney disease throughout the department’s divisions. Read ASN’s comment letter online at http://www.asn-online.org/policy_and_public_affairs/.
