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Expand chart
Note: Current through June 30, 2019; Data: United Network for Organ Sharing; Chart: Chris Canipe/Axios

President Trump signed an executive order yesterday modernizing kidney disease care for the first time in decades, a move that could reduce spending and improve treatment for one of the country's most pervasive illnesses.

Why it matters: This could be a big deal for the 37 million Americans suffering from chronic kidney disease, including 726,000 with kidney failure.

The big picture: The executive order requires Medicare to test different payment models encouraging preventive kidney care, home dialysis (versus facility-based dialysis) and kidney transplants.

  • The administration will also push for the development of artificial kidneys and speed up the kidney matching process so that more people can get transplants.
  • Almost 100,000 Americans are waiting for a kidney transplant, by far the most common organ transplant, and more than 100,000 begin dialysis each year.

The administration's goals are ambitious: It wants to reduce the number of patients with kidney failure by 25% by 2030, have 80% of patients who do develop it in 2025 either receive home dialysis or a kidney transplant, and double the number of kidneys available for transplant by 2030.

What they're saying: Encouraging home dialysis would obviously shake up the business models of dialysis clinic operators, namely the duopoly of DaVita and Fresenius. But they've already been moving in this direction, said Dan Mendelson, founder of Avalere Health.

  • "Home dialysis isn’t a full replacement for traditional dialysis, and the large chains have been preparing for this evolution for years," he said.

The bottom line: The focus on home dialysis and prevention are good for patients, and the executive order "could also reduce federal cost somewhat if implemented properly – but we need more detail to really assess that," Mendelson said.

Go deeper: The growing toll of kidney disease

Go deeper

The modern way to hire a big-city police chief

Illustration: Annelise Capossela/Axios

When it comes to picking a city's top cop, closed-door selection processes have been replaced by highly public exercises where everyone gets to vet the candidates — who must have better community-relations skills than ever.

Why it matters: In the post-George-Floyd era, with policing under utmost scrutiny, the choosing of a police chief has become something akin to an election, with the need to build consensus around a candidate. And the candidate pool has gotten smaller.

Felix Salmon, author of Capital
51 mins ago - Economy & Business

Speculative crypto art market takes off

Illustration: Aïda Amer/Axios

Move over, GameStop. The newest speculative game in town is NFTs — digital files that can be owned and traded on a plethora of new online platforms.

Why it matters: Most NFTs include some kind of still or moving image, which makes them similar to many physical art objects. Some of them, including a gif of Nyan Cat flying through the sky with a pop-tart body and rainbow trail, can be worth more than your house.

New coronavirus cases fall by 20%

Expand chart
Data: The COVID Tracking Project, state health departments; Map: Andrew Witherspoon/Axios

New coronavirus infections continued their sharp decline over the past week, and are now back down to pre-Thanksgiving levels.

The big picture: Given the U.S.’ experience over the past year, it can be hard to trust anything that looks like good news, without fearing that another shoe is about to drop. But the U.S. really is doing something right lately. Cases are way down, vaccinations are way up, and that’s going to save a lot of lives.