Published: Fri, July 12, 2019
Medicine | By Brett Sutton

Donald Trump says kidneys have special place in the heart

Donald Trump says kidneys have special place in the heart

Trump's strategy centers on changing how Medicare pays doctors and dialysis centers to boost their incentives to help patients get dialysis at home and keep them healthy enough to be eligible for transplantation. By 2025, the goal is to have 80% of people with newly diagnosed kidney failure getting one of those options, officials said.

President Trump on Wednesday told the government to revamp the nation's care for kidney disease, so that more people whose kidneys fail have a chance at early transplants and home dialysis.

But the changes won't happen overnight as some of the initiatives will require new government regulations. In touting the new effort, Health and Human Services Secretary Alex Azar and CMMI Director Adam Boehler spoke about how kidney disease has affected their families. Epstein's latest arrest over sex trafficking charges have renewed criticism of Acosta, and shed light on Mr. Trump's past interactions with Epstein.

For the Trump administration, kidney disease is personal.

Today's executive order comes as Congress discusses new legislation that will also improve kidney care.


The Comprehensive Kidney Care Contracting Models will open up capitated payments for kidney care patients to providers who will have responsibility for the total cost and quality of care for patients and share in Medicare savings. The demonstrations will, among other things, create incentives for dialysis providers to offer the treatment in a patient's home. Through DaVita Kidney Care, the company treats patients with chronic kidney failure and end stage renal disease. Almost 97,000 people are on the kidney transplant waiting list today, but in 2018 fewer than 22,000 kidney transplants were performed because there were not enough organs for all. The proposed mandatory ESRD Treatment Choices (ETC) Model, which would account for approximately 50% of Medicare beneficiaries with ESRD, would apply payment adjustments to the adjusted ESRD Prospective Payment System per treatment base rate to selected facilities, as well as the monthly capitation payment to selected clinicians, based on their home dialysis and kidney and kidney-pancreas transplant rates. Dialysis treatment runs on average about $89,000 a year, while a kidney transplant surgery averages about $32,000 and post-surgery care runs about $25,000 per year. "Many, many people are dying while they wait", said Trump before a room of people personally impacted by the disease.

In partnership with nephrologists, we are best positioned to deliver in the home dialysis space, as the largest provider of home dialysis in the U.S. We're accelerating home growth with our investments in technologies, such as home remote monitoring and a telehealth platform, to make it easier for patients to treat at home.

The Intermountain hospital system has started a project that helps identify kidney patients earlier in the process, and educate them on their options before they need dialysis or a transplant.

Statement Attributable to Javier Rodriguez, CEO for DaVita Inc.: "DaVita is encouraged that this Administration has taken steps toward holistic, value-based care for kidney patients".

"The longer you're on dialysis, the outcomes are worse", said Dr. Amit Tevar, a transplant surgeon at the University of Pittsburgh Medical Center, who praised the Trump administration initiatives. The new payment models are expected to start next year. The kidney care community welcomes the increased spotlight on promoting innovations in kidney care and improving patient outcomes, which provides a unique opportunity for partners in the public and private sectors to collaborate.

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