The Department of Health and Human Services launched a national kidney care plan on Tuesday that aims to lower the obstacles facing companies that want to compete with established dialysis providers, according to Axios.
HHS detailed its reasoning in the plan, saying the relative lack of innovation in kidney care is the structural outcome of anti-competitive and burdensome actions that have maintained the national crisis of kidney disease and kidney failure. The department said improving patient outcomes and reducing costs requires reviewing and modernizing the regulatory framework for kidney care to encourage competition, innovation and patient-centered care.
Health Secretary Robert F. Kennedy Jr. was set to unveil the plan in Fort Worth, Texas, on Tuesday, framing it as one piece of a wider push on chronic disease, according to Axios.
The plan blames heavy consolidation in dialysis, where DaVita and Fresenius Medical Care hold a combined share near 74%, according to Axios. It argues that this concentration gives the leading companies room to raise what they charge.
The plan also holds that excessive government intervention is partly to blame for the system's shortcomings. "In many cases, government should do less, focusing its efforts on promoting accountability, competition, and innovation," the plan recommends, according to The Hill. "An affirmative federal role is warranted in the narrow circumstances where a specific, identifiable market failure prevents private actors from serving the public interest," the plan says, according to The Hill.
On prevention, the plan points to Washington's position as the payer for treatment of end-stage renal disease as a major obstacle, according to Axios. That arrangement leaves private insurers with little reason to spend on earlier care, before patients become seriously ill, according to Axios. The plan suggests the Center for Medicare and Medicaid Innovation should help build a payment model aimed at improving how doctors diagnose and treat people in the early stages of kidney disease, according to Axios.
The plan seeks changes to the transplant system as well, calling for tighter supervision and improved incentives, according to Axios. HHS said it will push forward a National Transplant Expansion Strategy, which builds on a 2019 executive order issued during President Donald Trump's first term, according to The Hill. The strategy is meant to simplify the process of donating an organ while alive and to widen access to it, according to The Hill.
Close to 90,000 Americans are waiting for a kidney transplant, and a donor organ often takes three to five years to arrive, according to The Hill.
Kidney disease affects about 37 million adults in the United States, according to The Hill. Most of them are unaware of their condition, so care often starts only once substantial harm has been done, according to The Hill.