Jul 10, 2019

When the Body's Filter Fails to Function

Sandeep Patel, Open Innovation Manager at the U.S. Dept. of Health and Human Services. Photo: Chuck Kennedy for Axios

The big picture: Axios Health Care Business Reporter Bob Herman hosted a roundtable conversation on Tuesday to discuss innovations in chronic kidney disease treatment and care. Sitting down with experts across academia and the public and private sectors, the conversation highlighted the substantial burden placed on patients with chronic kidney disease, the importance of making continuing education for primary care providers accessible, and brainstorming ways of having earlier interventions.

Why it matters: 37 million Americans struggle with kidney disease, and often diagnosis comes after the kidneys are already severely impacted.

Education and early intervention
Tonya Saffer, Vice President of Health Policy at the National Kidney Foundation, in conversation at the Axios table. Photo: Chuck Kennedy for Axios

The conversation began with a discussion about the challenging classification of kidney disease, specifically how such narrow terminology misses identifying the interconnected nature of kidney disease in relation to other organs.

Tonya Saffer, Vice President of Health Policy at the National Kidney Foundation, discussed the difficulty of managing a population with kidney disease when many are living with undiagnosed conditions.

Michael Spigler, Vice President of Patient Services and Kidney Disease Education at the American Kidney Fund reiterated this point.

  • "Discovering too late can be fatal...People need time to understand what the options are and whether home dialysis is worth the lifestyle adjustments it requires"

Melissa West, the Project Director of the Kidney Health Initiative at the American Society of Nephrology stressed the importance of community and patient education.

  • "The more that we can communicate action and things happening, we can create more of a community...Hopefully we can empower patients."
Working with primary care providers
Axios health care business reporter Bob Herman moderating the roundtable discussion. Photo: Chuck Kennedy for Axios

Sandeep Patel, Open Innovation Manager at the U.S. Dept. of Health & Human Services discussed possible innovations in the first step of the diagnosis process — the visit to a primary care provider.

  • On the shift to home visits: "We expect primary care reimbursement to shift with half the country...When you look at primary care today, a significant amount of those visits could be home visits so why are they done in person?"
  • Restructuring payment: "Physicians get reimbursed by the number of in person visits...We need to change the reimbursement system to account for teledoc."
  • How to best serve rural communities: "The time is needed to transform and the resources are greater for rural areas...[We] need to hone in on what are the good things we are doing in these communities and what type of reimbursement programs are we are using."
Bringing innovative therapies to the market
Adam Boehler, Senior Advisor to the HHS Secretary and Deputy Administrator of the Center for Medicaid Services. Photo: Chuck Kennedy for Axios

Senior Advisor to the U. S. Department of Health and Human Services Secretary and Deputy Administrator of the Center for Medicaid Services, Adam Boehler, highlighted the forward-looking vision of the department.

  • On working together with treatment centers: "We are seeing reasonable deduction in hospitalization and a reorganization focused on the involvement of dialysis centers and working together."
  • On the role of technology: "Through apps and innovation, we’re changing how we organize and advance...HHS has launched an AI challenge for the identification treatment of kidney disease."

Thank you AstraZeneca for sponsoring this event.

Go deeper

Trump wants to stem the tide of kidney disease

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.

Go deeperArrowJul 11, 2019

The growing toll of kidney disease

Data: United States Renal Data System; Chart/Axios Visuals

Almost a quarter of traditional Medicare spending, or $114 billion, goes toward patients who have kidney disease. A large chunk of that, $35 billion, is spent on patients whose kidneys have failed and require dialysis or a transplant, according to the latest federal data.

Why it matters: Kidney disease diagnoses are growing, especially among older adults. Because treating it requires a lot of discomfort and money, the Trump administration is pushing for policies that will encourage more people to get dialysis treatment at home instead of in clinics, Politico reports.

Keep ReadingArrowJul 10, 2019

Health Care Vitals: Chicago

Kai Tao, Founder of Juno4Me, discusses the importance of preventative care at the Axios roundtable. Photo: Chris Dilts for Axios

This Wednesday, Axios' Sam Baker hosted an Expert Voices Live discussion in Chicago, digging into the state of health care access and affordability in Illinois.

Local leaders, health tech innovators, and advocates discussed solutions to challenges in health care policy and providing equitable, high-quality care.

Creating inclusive and comprehensive health care

How to measure the impact of effective care was a significant topic of conversation, as well as the fundamentally integrated nature of health across dental care, reproductive care, mental health services, and more.

  • Clark Stanford, Dean of the College of Dentistry at the University of Illinois at Chicago, discussed how dental health acts as a useful indicator for a person's overall health: "Health disparities are revealed in dental care — dental care reflects a patient's larger quality of life."
  • Felicia Davis, President and CEO of the Chicago Foundation for Women, unpacked the importance of measuring health outcomes versus outputs: "For example, if we give a girl a backpack, does her attendance improve? While saying we donated one thousand backpacks is measuring the output, we want to be measuring outcomes."
  • Paula Thornton Greear, Vice President of External Affairs for Planned Parenthood of Illinois, expressed support for measuring outcomes over outputs, and approaching the concept of health as not subdivided into different fields: "In reproductive health...we need to work with our partners in the mental health space. We need to put our best foot forward, but we can’t do it in a silo."
How to use data in providing better care

As health providers become increasingly dependent on data, the importance of accurate and accessible information is paramount in providing effective care.

  • Bonnie Lai, Head of Technology at Lumere, advocated for a more integrated approach to health data: "We need data to understand the needs of patients, but the data is siloed and it’s hard to break out of that."
  • Jason Montrie, President of Pareto Intelligence, stressed the need to make data more accessible to patients: "How do we democratize this data? That structure needs to be furthered. Patients should be able to change [their information] so it's always updated and accurate. [And then] how do we take the whole picture of someone, and give that to [a health care provider] who can act on that information?
Health insurance and challenges of access to care

Challenges presented by the complexities of the current systems and addressing the needs of all patients featured prominently in the conversation.

  • Laura Starr, Director of Development and Communications at CommunityHealth, focused on the importance of preventative and integrated care: "We need to do what’s most cost effective and that’s prevention...and integration makes everything more effective."
  • Kai Tao, Founder of Juno4Me discussed the challenges of the current health care systems and addressing the needs of different populations: "There are really three different health systems: Medicaid, employer-based, and Medicare. How can we lift everyone up? Especially when there are different levers, different populations to serve. What this goes back to is to start people young and focusing on preventative care."
    • Regarding the cherry-picking of patients with different types of coverage: "The reality is that dentists don’t want to see Medicare patients."

Thank you Delta Dental for sponsoring this event.

Keep ReadingArrowJul 25, 2019