Kidney Care Partners Letter to the Senate Finance Cmte. on Chronic Care

On behalf of the members of Kidney Care Partners (KCP), we appreciate the opportunity to submit comments as the Committee begins exploring solutions to improve outcomes for Medicare beneficiaries with chronic care needs. Senators Cardin, Crapo and Nelson have introduced S. 598, the Chronic Kidney Disease Improvement in Research and Treatment Act. The bill provides a holistic approach to improving the care of those with End State Renal Disease (ESRD) from research to treatment. Given the focus of the Working Group our comments will focus on three areas addressed in the legislation: a voluntary ESRD care coordination program, Medicare Advantage (MA) for Medicare beneficiaries with ESRD, and reauthorization Special Needs Plans (SNPs), though all provisions in the legislation are directly relevant to your work.

KCP is a coalition of patient advocates, dialysis professionals, care providers, and manufacturers dedicated to working together to improve the quality of care for those with renal failure. ESRD is an irreversible failure of kidney function that is fatal without a kidney transplant or dialysis treatments. Because of the limited number of kidneys available, about 70 percent of ESRD patients undergo dialysis, a process which removes wastes and fluid from the body.1 In 1972, Medicare was extended to cover all individuals with ESRD, regardless of age. Today, more than 80 percent of dialysis patients rely on Medicare.

There are over 26 million adults living with chronic kidney disease (CKD), which can lead to kidney failure if untreated. More than 636,000 Americans are living with kidney failure with about 430,000 of these individuals relying on dialysis. The number of individuals suffering from ESRD is expected to double over the next decade.

KCP applauds the Committee for its focus on chronic care. Addressing chronic conditions requires a coordinated approach to treatment. This is especially true for those suffering from ESRD. The ESRD patient population is complex and diverse. Most patients are living with multiple comorbidities. These patients often take more than eight different medications and are hospitalized at least twice each year. Given these facts, KCP believes it is critically important to incentivize opportunities for improved care coordination services. KCP members believe the policies contained in S. 598, especially those focused on improving care coordination for ESRD patients, should be a top consideration of the Committee.

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