Exclusive: HHS releases new kidney care plan
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Illustration: Shoshana Gordon/Axios
A new Trump administration plan for kidney care, provided first to Axios, calls for injecting more competition into treatment markets, incentivizing innovation and focusing more on preventive care.
Why it matters: Chronic kidney disease is common, expensive and deadly. But it often goes undetected until patients enter late stages when treatment options are more limited.
Driving the news: Health Secretary Robert F. Kennedy Jr. is announcing the plan today in Fort Worth, Texas, as part of a broader agenda aimed at fighting chronic disease.
- It comes on the heels of the a crackdown on organ donation organizations that are typically compensated 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 to the dialysis market — now dominated by industry giants DaVita and Fresenius — as well as the transplant system.
Between the lines: The plan takes the view that government overreach is 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 blames heavy consolidation, particularly within the dialysis market, where the two chains constitute roughly 74% of the market.
- This consolidation, it argues, allows dominant players to leverage their market power into higher prices.
- When it comes to prevention of kidney disease, the report argues that a primary barrier is the federal government's role in paying for end-stage renal disease care. That removes the incentive for private insurers to invest in more care before patients get very sick.
Details: The report calls for fewer barriers to competition in the dialysis market, better incentives and stronger oversight within the transplant system.
- It suggests that the Center for Medicare and Medicaid Innovation should have a role developing a payment model that promotes better diagnosis and treatment for patients with early-stage kidney disease.
The intrigue: The Department of Health and Human Services is calling for traditional free market approaches while framing a kidney care overhaul as squarely within Kennedy's chronic disease agenda.
