A new Trump administration plan for kidney care, provided first to Axios, calls for injecting more competition into treatment markets, encouraging innovation and focusing more on preventative care.
Why it’s important: Chronic kidney disease is common, costly and deadly. But it often goes unnoticed until patients enter advanced stages, when treatment options are more limited.
Driving the news: Health Secretary Robert F. Kennedy Jr. is announcing the plan Tuesday in Fort Worth, Texas, as part of a broader program to combat chronic disease.
- This follows a crackdown on organ donation organizations which are typically paid based on transplant and donation rates.
- The new plan takes a more holistic approach, proposing ways to address what it calls “structural deficiencies” in care.
- It calls for changes in the dialysis market – now dominated by industry giants DaVita and Fresenius – as well as the transplant system.
Between the lines: The plan sees government excesses as partly responsible for some of the system’s failures, arguing that “in many cases, government should do less, focusing its efforts on promoting accountability, competition, and innovation.”
- It also calls into question strong consolidation, particularly in the dialysis market, where the two chains constitute around 74% of the market.
- This consolidation, he argues, allows dominant players to exploit their market power to drive up prices.
- When it comes to kidney disease prevention, the report says the biggest barrier is the federal government’s role in funding end-stage kidney disease care. This leaves little incentive for private insurers to invest in more care before patients become seriously ill.
What’s inside: The report calls for reduced barriers to competition in the dialysis market, better incentives and stricter oversight within the transplant system.
- He suggests that the Center for Medicare and Medicaid Innovation should play a role in developing a payment model that promotes better diagnosis and treatment for patients with early-stage kidney disease.
The plot: The Department of Health and Human Services calls for traditional free-market approaches while framing an overhaul of kidney care as directly within Kennedy’s chronic disease agenda.
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