President Trump Signs Kidney Health Executive Order, Announces New Kidney Treatment Payment Bundle > Hospital Association of Pennsylvania


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President Trump Signs Kidney Health Executive Order, Announces New Kidney Treatment Payment Bundle

July 15, 2019

Last week, President Donald Trump signed an executive order to launch the “Advancing American Kidney Health” initiative. The three-pronged executive order is aimed at revamping the way America treats kidney disease.

The plan’s aim is to:

  • Reduce the number of Americans with end-stage renal disease by increasing preventive care
  • Incentivize the use of home dialysis or kidney transplants to reduce the use of high-cost dialysis centers
  • Encourage the development of artificial and wearable kidneys and modernizing the organ recovery and transplantation system

Currently, $114 billion of Medicare funding is spent on patients who have kidney disease. The government’s goal is to reduce the number of patients with end-stage renal disease by 25 percent by 2030 in an effort to help lower health care costs.

It is estimated that 340 people begin dialysis treatment for kidney failure, but only 12 percent receive treatment in their homes. The U.S. Department of Health and Human Services is aiming at having at least 80 percent of patients receiving in-home dialysis or a viable organ transplant.

In order to meet the goals of the initiative, the Center for Medicare and Medicaid Innovation introduced five new payment models. The End-Stage Renal Disease Treatment Choices model—designed to incentivize home dialysis and transplantation—will be mandatory in some geographic areas and is expected to begin January 1, 2020 and end June 30, 2026. The remaining payment models, including the Kidney Care First (KCF) and the Comprehensive Kidney Care Contracting (CKCC) models, are voluntary.  

The KCF model provides a fixed payment to providers to manage patients with kidney disease. The CKCC model offers varying levels of risk sharing to providers for managing patients with kidney disease. It is expected that more than 200,000 Medicare enrollees will participate in one of these models during the course of the program.

The Trump Administration’s announcement demonstrates a growing focus on the transition from paying hospitals for the quantity of patients they see move to value-based payment arrangements, wherein providers are reimbursed for the quality and outcomes of the care they provide. HAP continues to support providers in the transition to value-based payment by advocating for measure consolidation and access to meaningful data for managing populations.

For additional information, contact Kate Slatt, HAP’s senior director, innovative payment and care delivery.

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