Background

On July 10, 2019, President Donald Trump signed an Executive Order to launch Advancing American Kidney Health, a new initiative designed to improve the lives of Americans with kidney disease by expanding treatment options and reducing health care costs. The initiative proposes various changes, including revising rules to ensure kidneys reach patients quicker, moving more patients into home dialysis, encouraging development of artificial kidneys, increasing the number of kidneys available for transplantation, and changing reimbursement for kidney disease treatment.

As directed by the Executive Order, the U.S. Department of Health and Human Services (HHS) announced  that the Centers for Medicare & Medicaid Services (CMS), through its Center for Medicare and Medicaid Innovation (CMMI), released a proposed required payment model and four optional payment models to adjust payment incentives to encourage preventative kidney care, home dialysis, and kidney transplants. The Department’s Assistant Secretary for Planning and Evaluation (ASPE) also released a paper entitled Advancing American Kidney Health.

Executive Order

• Advancing American Kidney Health (HHS wepage)
• Advancing American Kidney Health (HHS document, 7/10/19)
• Executive Order on Advancing American Kidney Health (7/10/19)
• HHS Launches President Trump’s ‘Advancing American Kidney Health’ Initiative (HHS Press Release, 7/10/19)
• HHS To Transform Care Delivery for Patients with Chronic Kidney Disease (CMS Press Release, 7/10/19)
• Advancing American Kidney Health Paper
• HHS Marks One-Year Anniversary of Advancing American Kidney Health Initiative (HHS Press Release, 7/10/20)
• HHS Reports Progress on President Trump's 'Advancing American Kidney Health' Initiative (HHS Press Release, 8/17/20)
• Advancing American Kidney Health: 2020 Progress Report (HHS, 8/17/20)

Activities & Implementation

• CMS ESRD Treatment Choices (ETC) Model
  • CMS Final Rule: Medicare Program; Specialty Care Models to Improve Quality of Care and Reduce Expenditures (CMS-5527-F) (9/18/20)
  • CMS Press Release: CMS Announces Transformative New Model of Care for Medicare Beneficiaries with Chronic Kidney Disease (9/18/20)
  • CMS Fact Sheet: ESRD Treatment Choices (ETC) Fact Sheet (9/18/20)
  • ANNA Submits Comments to CMS Regarding CMS-5527-P: Medicare Program; Specialty Care Models to Improve Quality of Care and Reduce Expenditures (9/16/19)
  • Letter from the Alliance for Home Dialysis to CMS Regarding CMS-5527-P: Medicare Program; Specialty Care Models to Improve Quality of Care and Reduce Expenditures (9/16/19)
  • Letter from Kidney Care Partners to CMS Regarding CMS-5527-P: Medicare Program; Specialty Care Models to Improve Quality of Care and Reduce Expenditures (9/15/19)
  • CMS Proposed Rule: Medicare Program; Specialty Care Models to Improve Quality of Care and Reduce Expenditures (CMS-5527-P) (7/18/19)
  • CMS Fact Sheet: Proposed ESRD Treatment Choices (ETC) Mandatory Model (7/10/19)

• CMS Kidney Care Choices Model
• CMS Fact Sheet: Kidney Care Choices Model (12/4/19)
• CMS Fact Sheet: Kidney Care First and Comprehensive Kidney Care Contracting Models (7/10/19)
• CMS Proposed Rule: Organ Procurement Organization (OPO) Conditions for Coverage Proposed Rule: Revisions to Outcome Measures for OPOs (CMS-3380-P) (12/23/19)
• CMS Fact Sheet: Organ Procurement Organization (OPO) Conditions for Coverage Proposed Rule: Revisions to Outcome Measures for OPOs (12/17/19)
• Health Resources & Services Administration (HRSA) Proposed Rule: Removing Financial Disincentives to Living Organ Donation (42 CFR Part 121) (12/20/19)
• HRSA Fact Sheet: Notice of Proposed Rulemaking (NPRM) to amend the regulations implementing the National Organ Transplant Act of 1984 (NOTA) (12/19)
• HHS Press Release: Trump Administration Proposes New Rules to Increase Accountability and Availability of the Organ Supply (12/17/19)
• CMS Final Rule: Medicare Program: ESRD Prospective Payment System, Payment for Renal Dialysis Services Furnished to Individuals with Acute Kidney Injury, etc. (CMS-1713-F) (11/8/19)

Response from ANNA

"The Advancing American Kidney Health initiative provides an opportunity for nephrology nurses and the American Nephrology Nurses Association (ANNA) to be strategic and forward thinking about what we have to offer as a profession," said 2019 ANNA President Tamara Kear, PhD, RN, CNS, CNN, FAAN. "Successful implementation of the initiative will require the active involvement of nephrology nurses who possess the necessary education, training, and clinical skills to provide the most effective care to patients with kidney disease in all settings. Nephrology nurses must not only be at the table as the American Kidney Health initiative is implemented, we must have a leading role as full partners with the HHS and CMS, industry leaders, practitioners, and patient organizations as the initiative moves forward. ANNA and our colleagues in the kidney care community will continue to work together to share updated information and resources with our members throughout this process."

News & Updates

• An Opportunity to Advance Kidney Health Becomes a Responsibility (Nephrology Nursing Journal, July/August 2020)
• Implications of Proposed Changes to Models of Care for Kidney Disease (American Journal of Nursing, July 2020)
• Investment in Time, Resources Needed to Prepare Nephrology Nurses for Training Patients and Caregivers in Home Dialysis Delivery (Kidney News Online, February 2020)
• Advancing American Kidney Health – The Time for Nurses to Act Is Now (Message from ANNA President, Nephrology Nursing Journal, November/December 2019)
• Nurses Look at Challenges, Opportunities of Advancing American Kidney Health (Nephrology News & Issues, December 2019)
• An Era of Transformation (Message from ANNA President, Nephrology Nursing Journal, September/October 2019)
• ANNA Submits Comments to CMS Regarding CMS-1713-P: Medicare Program; ESRD PPS, Payment for Renal Dialysis Services Furnished to Individuals with AKI, ESRD QIP (9/25/19)
• ANNA Submits Comments to CMS Regarding CMS-5527-P: Medicare Program; Specialty Care Models to Improve Quality of Care and Reduce Expenditures (9/16/19)

Events

2020 ANNA National Symposium

The following educational session was featured at the ANNA National Symposium on August 31, 2020:

Advancing American Kidney Health: Update on the Executive Order and ANNA’s Action (1.0 CH)

Go to Session Archive

2019 Nephrology Nursing Practice, Management, & Leadership Conference

Updated 9/18/20