Trump unveils plan to help kidney patients in push to lower health costs

President Trump on Wednesday signed an executive order that he says would improve the lives of patients with kidney disease while lowering health care costs. 

Kidney disease, the ninth leading cause of death in the United States, makes up 20 percent of Medicare’s payments to providers per year, and the proposal is expected to save about $4.2 billion annually. 

The order signed by Trump would direct the Department of Health and Human Services (HHS) to revamp a system that currently favors more expensive treatment in commercial dialysis centers.

{mosads}It aims to address the U.S. organ shortage by incentivizing people to donate while increasing scrutiny of the 58 nonprofits that collect organs from deceased donors. 

And it would emphasize early treatment to slow the progression of kidney disease, as well as early transplants and home-based dialysis for those with end-stage kidney failure. 

“This action will dramatically improve prevention and treatment of this life-threatening illness while making life better and longer,” Trump said at a signing ceremony Wednesday, surrounded by patients. 

By 2025, HHS wants 80 percent of new patients to either be receiving dialysis at home or receiving a transplant. 

The order relies on agency action, so changes may not take effect for several months. 

The proposal would shake up a multibillion-dollar industry that relies on commercial dialysis centers instead of home-based services that can be easier for patients.

Currently, only 12 percent of dialysis patients receive treatment at home. 

While DaVita and Fresenius Medical Care, two big dialysis companies, have started offering home-based treatment, most of their business still takes place in clinics. 

DaVita’s stock fell 5.3 percent Tuesday in anticipation of the announcement, while another dialysis company, American Renal Associates Holdings, saw declines of 9.6 percent. 

“It is mentally and physically draining on you as an individual,” said HHS Secretary Alex Azar, whose father needed dialysis before receiving a transplant. 

“You then spend a day recovering and by the time you’re recovered from that process, you’ve got to get back to the center.” 

Trump likened dialysis to a “full-time job.” 

“Those who suffer from kidney disease experienced a significant toll on their daily lives,” he said. 

Early treatment and transplants are preferable to dialysis, which keeps patients alive but can weaken the immune system, according to Azar. 

About 50 percent of dialysis patients will die within five years, Azar added. 

To make more kidneys available for transplant, the administration plans to crack down on the 58 groups that collect transplant organs. 

Some of these organs are discarded for minor reasons or are not delivered to transplant centers on time, experts say. 

The organ-procurement system in the United States hasn’t been updated in decades, and thousands of people a year die waiting for kidney transplants. There are nearly 100,000 people on waiting lists to receive kidney transplants. 

The new rules will ensure organs “reach waiting patients as quickly as possible, because oftentimes they just don’t make it in time,” Trump said. 

“We are going to make it so that it gets there in time and we’ll establish more transparent, enforceable and objective metrics for identifying potential kidneys for transplant.”

HHS will also issue regulations allowing organ donors to be reimbursed for lost wages and child care expenses. 

In all, the administration estimated that the changes would result in the donation of 17,000 more kidneys a year. 

The proposal is part of Trump’s efforts to broaden his health care agenda beyond calling for the repeal of the Affordable Care Act (ACA), also known as ObamaCare. Health care has consistently polled as a top issue for voters heading into the 2020 elections.  

The efforts are likely to strike a chord with older voters, as most people who are diagnosed are older adults. 

But Democrats also note that the Trump administration is pushing to have the ACA overturned in court, which would impact those with kidney disease and millions others with pre-existing conditions.  

Trump on Wednesday also touted his efforts to end HIV, curb the opioid epidemic, increase price transparency in health care and invest in child cancer cures. 

“As part of our commitment to ensuring great health care for every American, my administration has already launched many bold initiatives to battle major diseases and save American lives,” Trump said.

Trump’s kidney efforts are bipartisan and unlikely to face any major pushback from Congress. 

“The goals of increasing the rate of transplants and home dialysis, which are both better options for most patients and better for the sustainability of Medicare as a whole, are meaningful steps in the right direction,” said Reps. Suzan DelBene (D-Wash.) and Larry Bucshon (R-Ind.), co-chairs of the Congressional Kidney Caucus.