Advances in chronic kidney disease最新文献_第7页

Centers for Medicare & Medicaid Services' Models to Improve Late-stage Chronic Kidney Disease and End-stage Renal Disease Care: Leveraging Nephrology Payment Policy to Achieve Value 医疗保险和医疗补助服务中心改善晚期慢性肾病和终末期肾病护理的模式:利用肾病支付政策实现价值

IF 2.9 3区医学

Advances in chronic kidney disease Pub Date : 2022-01-01 DOI: 10.1053/j.ackd.2021.12.001

Siddhartha Mazumdar, Kathleen Blackwell, Tom Duvall, Gregory Boyer, Laura Missett

{"title":"Centers for Medicare & Medicaid Services' Models to Improve Late-stage Chronic Kidney Disease and End-stage Renal Disease Care: Leveraging Nephrology Payment Policy to Achieve Value","authors":"Siddhartha Mazumdar, Kathleen Blackwell, Tom Duvall, Gregory Boyer, Laura Missett","doi":"10.1053/j.ackd.2021.12.001","DOIUrl":"10.1053/j.ackd.2021.12.001","url":null,"abstract":"<div><p>This article describes two new and complementary initiatives from the Center for Medicare and Medicaid Innovation at the Centers for Medicare & Medicaid Services—the ESRD Treatment Choices and Kidney Care Choices Models—which focus on Medicare beneficiaries with CKD and ESRD. These models, or time-limited tests, are aimed at testing whether modifying Medicare payment methodologies, while also rewarding certain clinical outcomes, will improve treatment and outcomes and reduce costs. Together, these initiatives comprise a major part of the larger federal effort to improve the lives of people with kidney disease. The goal of the ESRD Treatment Choices Model is to maintain or improve quality while reducing cost by incentivizing greater use of home dialysis and kidney transplantation. The model aims to do so by adjusting certain payments to nephrologists and other clinicians managing beneficiaries with ESRD (managing clinicians) and ESRD facilities selected to participate in the model. The Kidney Care Choices Model aims to maintain or improve quality while reducing cost through better coordination of care across a larger spectrum of kidney disease, focusing on beneficiaries with CKD stages 4 and 5 and ESRD, to delay the onset of ESRD and improve the transition for Medicare beneficiaries facing the prospect of dialysis. The Centers for Medicare & Medicaid Services is hopeful that these models will inform the future direction of payment policy for this critical Medicare population.</p></div>","PeriodicalId":7221,"journal":{"name":"Advances in chronic kidney disease","volume":"29 1","pages":"Pages 24-29"},"PeriodicalIF":2.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1548559521001609/pdfft?md5=7d7ac4b9fb7c4a08010c6ad1c3715831&pid=1-s2.0-S1548559521001609-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58235149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Nephrology Policy: Kidney Transplantation 肾病政策：肾移植。

IF 2.9 3区医学

Advances in chronic kidney disease Pub Date : 2022-01-01 DOI: 10.1053/j.ackd.2022.02.007

Miriam Godwin

引用次数: 1

Multiple Stakeholder Perspectives on the Reinvigorated Case for Kidney Disease Screening 从多方利益相关者的角度重新审视肾脏疾病筛查

IF 2.9 3区医学

Advances in chronic kidney disease Pub Date : 2022-01-01 DOI: 10.1053/j.ackd.2021.11.008

Miriam Godwin , Amber Pettis , Joseph A. Vassalotti

引用次数: 0

Realizing the Goals of the Advancing American Kidney Health Initiative: Toward a Better Future for Kidney Disease Research Funding 实现推进美国肾脏健康倡议的目标：为肾脏疾病研究基金创造更美好的未来。

IF 2.9 3区医学

Advances in chronic kidney disease Pub Date : 2022-01-01 DOI: 10.1053/j.ackd.2022.01.005

Ryan Murray , Holly Kramer

{"title":"Realizing the Goals of the Advancing American Kidney Health Initiative: Toward a Better Future for Kidney Disease Research Funding","authors":"Ryan Murray , Holly Kramer","doi":"10.1053/j.ackd.2022.01.005","DOIUrl":"10.1053/j.ackd.2022.01.005","url":null,"abstract":"<div><p>The Executive Order on Advancing American Kidney Health aimed to slow the progression of kidney disease, increase access to kidney transplantation, and expand home dialysis. In order to support the kidney health strategy laid out by the Advancing American Kidney Health, the National Institutes of Health, the National Institute of Diabetes, and Digestive, and Kidney Diseases, as well as other funding agencies must dedicate robust research funding to kidney disease. Currently, federal research investment for kidney health is less than 1% of Medicare fee-for-service expenditures for Americans with kidney disease. To address disparities in federal research funding, nephrology organizations are working together to advocate for increased federal commitment to kidney disease research. Underfunding of kidney disease research impedes scientific opportunities and innovation and prevents the collaboration of young investigators with research faculty that can accelerate the exodus of talent within the nephrology research workforce. This review provides an overview of the current state of federal research funding for kidney disease within the United States. In addition, we discuss ongoing advocacy efforts and programs that aim to increase federal funding for kidney-related research and accelerate the development of new and better therapies.</p></div>","PeriodicalId":7221,"journal":{"name":"Advances in chronic kidney disease","volume":"29 1","pages":"Pages 76-82"},"PeriodicalIF":2.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1548559522000040/pdfft?md5=ce59830fb1b0b22481928e5639e73d92&pid=1-s2.0-S1548559522000040-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47580787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Health Policy Trends in Kidney Disease 肾脏疾病的卫生政策趋势。

IF 2.9 3区医学

Advances in chronic kidney disease Pub Date : 2022-01-01 DOI: 10.1053/j.ackd.2022.03.002

Miriam Godwin MPP, Eugene Lin MD, MS

引用次数: 0

Value-Based Care and Kidney Disease: Emergence and Future Opportunities 基于价值的护理和肾脏疾病:出现和未来的机会

IF 2.9 3区医学

Advances in chronic kidney disease Pub Date : 2022-01-01 DOI: 10.1053/j.ackd.2021.10.001

Sri Lekha Tummalapalli , Mallika L. Mendu

{"title":"Value-Based Care and Kidney Disease: Emergence and Future Opportunities","authors":"Sri Lekha Tummalapalli , Mallika L. Mendu","doi":"10.1053/j.ackd.2021.10.001","DOIUrl":"10.1053/j.ackd.2021.10.001","url":null,"abstract":"<div><p>The United States health care system has increasingly embraced value-based programs that reward improved outcomes and lower costs. Health care value, defined as quality per unit cost, was a major goal of the 2010 Patient Protection and Affordable Care Act amid high and rising US health care expenditures. Many early value-based programs were specifically designed for patients with end-stage renal disease (ESRD) and targeted toward dialysis facilities, including the ESRD Prospective Payment System, ESRD Quality Incentive Program, and ESRD Seamless Care Organizations. While a great deal of attention has been paid to these ESRD-focused programs, other value-based programs targeted toward hospitals and health systems may also affect the quality and costs of care for a broader population of patients with kidney disease. Value-based care for kidney disease is increasingly relevant in light of the Advancing American Kidney Health initiative, which introduces new value-based payment models: the mandatory ESRD Treatment Choices Model in 2021 and voluntary Kidney Care Choices Model in 2022. In this review article, we summarize the emergence and impact of value-based programs on the quality and costs of kidney care, with a focus on federal programs. Key opportunities in value-based kidney care include shifting the focus toward chronic kidney disease, enhancing population health management capabilities, improving quality measurement, and leveraging programs to advance health equity.</p></div>","PeriodicalId":7221,"journal":{"name":"Advances in chronic kidney disease","volume":"29 1","pages":"Pages 30-39"},"PeriodicalIF":2.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9199582/pdf/nihms-1749064.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10825829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

ETC Model: How One Small Dialysis Organization Is Navigating Uncharted Policy Waters ETC模型：一家小型透析机构如何在未知的政策水域中航行

IF 2.9 3区医学

Advances in chronic kidney disease Pub Date : 2022-01-01 DOI: 10.1053/j.ackd.2022.01.001

J. Ganesh Bhat , Steven Weiss

引用次数: 1

Resolving the Debate: The Future of Using Race in Estimating Kidney Function 解决争论:用种族估计肾功能的未来。

IF 2.9 3区医学

Advances in chronic kidney disease Pub Date : 2022-01-01 DOI: 10.1053/j.ackd.2022.02.001

Cynthia Delgado , Neil R. Powe

{"title":"Resolving the Debate: The Future of Using Race in Estimating Kidney Function","authors":"Cynthia Delgado , Neil R. Powe","doi":"10.1053/j.ackd.2022.02.001","DOIUrl":"10.1053/j.ackd.2022.02.001","url":null,"abstract":"<div><p>Racial and social unrest witnessed during 2020 ignited a national conversation about the appropriateness of the use of race in health care algorithms and in the estimation of kidney function in particular. The growing concerns over the use of race in kidney function–estimating equations prompted the National Kidney Foundation (NKF) and American Society of Nephrology to launch an effort for change by establishing a task force on reassessing the use of race in diagnosing kidney disease. After nearly a year examining the evidence and obtaining testimony from experts and stakeholders, the task force recommended the immediate implementation of the 2020 Chronic Kidney Disease-Epidemiology creatinine equation refit without race in all US laboratories; increased routine use of cystatin C for confirmation of estimated glomerular filtration rate in clinical decision-making and a call for research on glomerular filtration rate estimation with new endogenous filtration markers and on addressing disparities in health and health care. The NKF and American Society of Nephrology strongly encouraged rapid adoption of these new recommendations. Leadership efforts of the NKF have begun to lay the foundation for national implementation through laboratory engagement, clinician awareness, and patient education.</p></div>","PeriodicalId":7221,"journal":{"name":"Advances in chronic kidney disease","volume":"29 1","pages":"Pages 5-16"},"PeriodicalIF":2.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1548559522000179/pdfft?md5=c8978c75ceea9338b9e4e583ca82977b&pid=1-s2.0-S1548559522000179-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46422687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

From Home Dialysis Access to Home Dialysis Quality 从家庭透析接入到家庭透析质量。

IF 2.9 3区医学

Advances in chronic kidney disease Pub Date : 2022-01-01 DOI: 10.1053/j.ackd.2022.02.010

Eric D. Weinhandl , Derek Forfang

{"title":"From Home Dialysis Access to Home Dialysis Quality","authors":"Eric D. Weinhandl , Derek Forfang","doi":"10.1053/j.ackd.2022.02.010","DOIUrl":"10.1053/j.ackd.2022.02.010","url":null,"abstract":"<div><p>The number and percentage of patients dialyzing at home has steadily increased during the past decade, and federal policy initiatives have driven interest to a new high. However, the mere utilization of home dialysis does not ensure better outcomes for patients and care partners. Although public reporting systems for dialysis quality are mature and robust, the incorporation of home dialysis quality in those systems is immature; the advent of the End-Stage Renal Disease Treatment Choices payment model brings this problem into sharp relief. The home dialysis modalities present both common and unique targets for quality measurement. For both modalities, therapy duration (or its inverse, technique failure) is a potential target. For peritoneal dialysis, peritonitis, catheter complications, and residual kidney function are additional targets; for home hemodialysis, vascular access infections, dialysis adequacy, and treatment adherence are targets. Patient-reported experience measures are also important; this domain is a long-standing disparity, as in-facility hemodialysis patients have been routinely surveyed for several years. The statistical aspect of quality measurement in home dialysis requires some adaptation, as the typical home dialysis program is small, thus presenting a threat to reliability; pooling programs may be necessary. Ultimately, promoting high-quality home dialysis will likely increase utilization of home dialysis.</p></div>","PeriodicalId":7221,"journal":{"name":"Advances in chronic kidney disease","volume":"29 1","pages":"Pages 52-58"},"PeriodicalIF":2.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1548559522000386/pdfft?md5=9b2f4a8a816c5555292a142f76b524cd&pid=1-s2.0-S1548559522000386-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47796011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Current State of Multiorgan Transplantation and Implications for Future Practice and Policy 多器官移植的现状及其对未来实践和政策的影响。

IF 2.9 3区医学

Advances in chronic kidney disease Pub Date : 2021-11-01 DOI: 10.1053/j.ackd.2021.09.012

Scott G. Westphal, Eric D. Langewisch, Clifford D. Miles

{"title":"Current State of Multiorgan Transplantation and Implications for Future Practice and Policy","authors":"Scott G. Westphal, Eric D. Langewisch, Clifford D. Miles","doi":"10.1053/j.ackd.2021.09.012","DOIUrl":"10.1053/j.ackd.2021.09.012","url":null,"abstract":"<div><p>The incidence of kidney dysfunction has increased in liver transplant and heart transplant candidates, reflecting a changing patient population and allocation policies that prioritize the most urgent candidates. A higher burden of pretransplant kidney dysfunction has resulted in a substantial rise in the utilization of multiorgan transplantation (MOT). Owing to a shortage of available deceased donor kidneys, the increased use of MOT has the potential to disadvantage kidney-alone transplant candidates, as current allocation policies generally provide priority for MOT candidates above all kidney-alone transplant candidates. In this review, the implications of kidney disease in liver transplant and heart transplant candidates is reviewed, and current policies used to allocate organs are discussed. Important ethical considerations pertaining to MOT allocation are examined, and future policy modifications that may improve both equity and utility in MOT policy are considered.</p></div>","PeriodicalId":7221,"journal":{"name":"Advances in chronic kidney disease","volume":"28 6","pages":"Pages 561-569"},"PeriodicalIF":2.9,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1548559521001014/pdfft?md5=f0416268a21d0220c7f278109ff1ad3a&pid=1-s2.0-S1548559521001014-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49013181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1