Advancing American Kidney Health is an initiative to improvekidney care in the United States which was launched throughExecutive Order by PresidentDonald Trump on July 10, 2019.[1]
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In 2019,chronic kidney disease was estimated to have aprevalence of more than 15 percent among adults in the United States, and nearly 100,000 Americans were waiting for akidney transplant.[2][3] The purpose of theAdvancing American Kidney Health initiative was to improve this situation and thereby reducehealthcare costs[4] by encouraging preventive modes of care, creating incentives to increase the proportion ofhome dialysis treatment and making kidney transplants available to more patients.
The initiative stated three explicit goals: to ensure that 80 percent of patients newly diagnosed with kidney failure would either receive a transplant or at-home dialysis by 2025; to reduce the instances of kidney failure by one fourth by 2030; to make twice as many kidneys available for transplant by 2030.[5] The means to achieve the goals would include a restructuring of payment models withinMedicare, thus making home therapy more financially attractive and in-center therapy less so.[3]
The initiative was generally well received at the time of launch,[6] with patient advocates and officials within theUnited States Department of Health and Human Services commenting that the existing health system for kidney care was overdue for reform and had failed to create incentives for early detection andprevention.[7] The implementation of reforms was slowed down by the impact of the 2020COVID-19 pandemic.[4]