Local kidney-care leaders praise Trump’s push for organ donation, home dialysis

Leaders from local hospitals, nonprofits and companies that provide dialysis and kidney transplants spoke positively Wednesday about President Trump’s executive order that would push for early intervention in kidney disease.

The far-reaching order encourages more dialysis to be conducted at home, aims to double the number of kidney transplants annually and rewards kidney doctors whose patients show better health outcomes.

There are 37 million Americans with chronic kidney disease and more than 726,000 with endstage renal disease, according to the White House. About 100,000 people in the U.S. are waiting to receive a kidney transplant.

“Reforming how we prevent kidney disease and how we provide the care is a terrific model for transforming the U.S. health care system into one that emphasizes wellness and prevention as opposed to what we have now,” said Dr. Barry Smith, CEO of the nonprofit Rogosin Institute, which provides kidney care and dialysis services.

Medicare plans to test new payment models that will incentivize doctors to delay the onset of kidney failure when patients must begin dialysis and to prevent hospitalizations. The program includes different tracks that will encourage nephrologists and kidney-care practices to meet certain cost benchmarks. One track would allow the doctors to earn bonuses without risking any penalties. Another would allow doctors to risk payment penalties if their patients costs are higher than expected.

“That’s pretty ambitious,” Smith said of the plan to have nephrologists take on more risk for their patients. “It’s not a wrong goal but it’s ambitious.”

Another payment model would reward doctors whose patients move to home dialysis or get kidney transplants with the goal of improving patients’ quality of life and saving money for Medicare.

“I’m excited about partnering more with nephrologists and dialysis companies on demonstration projects that incentivize patients to get a transplant more quickly, because kidney transplants are less expensive than maintaining patients on dialysis,” said Brigitte Sullivan, director of NYU Langone’s Transplant Institute.

Spending in the traditional Medicare program on services for people with chronic kidney disease and end-stage renal disease in 2016 was $114 billion, which represented nearly one-quarter of spending.

“It’s going to make a really big difference in millions of people’s lives and in the budget. This is one of the most expensive segments of Medicare right now,” said Henry Kauftheil, chairman and co-founder of Dialyze Direct, a Brooklyn-based company that provides dialysis services in nursing homes.

The Trump administration’s plan would double the number of kidney transplants annually to 34,000, in part by lowering the number of kidneys that are discarded because of inefficient matching between donors and recipients.

The initiative also looks to bolster organ donation by increasing the reimbursement allowed for travel, lost wages and child care expenses for living donors. New York has consistently ranked at or near the bottom of states in the percentage of residents registered as organ donors.

“These volunteers are our greatest treasure, and now there’s a pathway for these heroes to be funded,” Dr. Lewis Teperman, director of organ transplantation at Northwell Health, said in a statement supporting the plan.