The milestone year of 2023 marks the 50th anniversary of the Medicare End Stage Renal Disease (ESRD) program. This program is an important exception to Medicare coverage, which also covers individuals under 65 years of age.
Mandated by Congress, the ESRD Network was established in 1978 to ensure quality of care for patients receiving treatment. dialysis Kidney transplant. Over the years, the ESRD program has experienced remarkable growth, with consistent increases in the number of dialysis patients and new dialysis clinics. However, in an unprecedented change, the number of dialysis patients has recently decreased, leading to the closure of hundreds of dialysis clinics across the country from 2022 to 2023.
To put this in perspective, approximately 1,200 dialysis clinics were added between 2017 and 2021, resulting in a net increase of 300 to 400 clinics each year. It is unclear whether these developments indicate a decline in the number of ESRD cases or unfavorable factors such as the number of coronavirus-related deaths.
However, there have also been positive developments. Although the number of home dialysis patients continues to increase, challenges remain in subsidizing home dialysis. Additionally, a record 25,498 kidney transplants were performed in 2022, an increase of 3.4% from the previous year. Efforts to promote health equity are strengthened through the new ESRD Quality Incentive Plan (QIP), a step toward more equitable kidney care delivery.
However, trends regarding vascular access for dialysis include a particular increase in the use of dialysis catheters. This trend predates the COVID-19 pandemic and may be an unintended consequence of shared decision-making, resulting in patients with advanced CKD and their care partners preparing for dialysis transition with urgency. They are authorized to postpone until the need arises (often during an unplanned hospitalization).
Additionally, 2023 will be the second year of the value-based care model in practice. These voluntary models expand renal care to include the pre-dialysis phase of CKD, including stages 4 and 5.
Online hemodiafiltration in outpatient dialysis clinics has become an established option in many countries except the United States.of Convince a randomized trialrecently published New England Medical Journal, demonstrated excellent survival rates. This breakthrough could soon close his 20-year technology gap in U.S. dialysis clinics and usher in a new era of higher-level kidney treatment options.
In the face of these challenges and innovations, we recognize that dialysis, even in its traditional form, continues to extend the lives of many, providing hope and resilience in the face of organ failure. That is essential.
As the landscape of ESRD care evolves, there is a collective effort to address uncertainty, embrace progress, and ensure that everyone faces challenges. Challenge to kidney health You will receive the best possible choice, care and support.
