By Dr. Rob Kossman and Joe Turk
Last year, the U.S. Department of Health and Human Services announced the Advancing American Kidney Health Initiative to encourage home dialysis and transplant for people living with kidney failure. As the agency prepares to roll out final payment models under this new program, it will be yet another step toward a paradigm shift in kidney care. It’s a shift that industry leaders like Fresenius Medical Care have long embraced, having already invested billions of dollars toward supporting home dialysis, improving outcomes, and reducing total cost of care.
Of the approximately 800,000 Americans currently living with kidney failure, about a third are living with a kidney transplant, the best option for treatment. While the vast majority of those not receiving a transplant will receive dialysis in-center three times a week, a growing number of patients are performing dialysis in their own home. It’s a treatment option that can provide more independence, higher quality of life, and better health outcomes. Now, with more support and training, and better technology and connected health options, home dialysis should really be considered the first choice, after kidney transplant, for all patients. Medicare spends $36 billion a year to care for those living with kidney failure. We strongly believe home dialysis offers a lower-cost-of-care setting while improving patient outcomes.
Eighteen months ago, our company merged with NxStage Medical, a leader in innovative home dialysis equipment, with a goal to rapidly accelerate home dialysis options for all patients. We knew it would be hard work. Increasing the number of kidney patients receiving home dialysis requires engaged physician partners, high-touch patient and physician education, dedicated care teams, committed government partners, and a company that puts patients at the center of everything we do. We could never have expected such tremendous success in such a short period of time.
The number of home dialysis treatments has increased by 15 percent compared to a year ago, with home hemodialysis treatments growing by more than 40 percent. And June was the strongest month on record with regard to the number of patients being trained for home dialysis. We’ve done this by increasing our home clinical support staff by more than 30 percent and doubling the number of patients we train each month. This commitment continued through the challenges of the COVID-19 pandemic, and in June of this year, more patients were trained to start home dialysis – both peritoneal dialysis and home hemodialysis – than ever before.
We believe in home dialysis and what it does for patients. Today, we are expanding home dialysis like no one else. Our commitment began years ago by first building out the products, services, and support for patients, staff, and doctors to be able to be successful at home. We have only just begun in our goal to transform kidney care.
We recently launched an aggressive strategy of opening more transitional care units, which provides intensive education and training, resulting in around 50 percent of those patients choosing home dialysis modalities to date. We made a major commitment to telemedicine expansion, with more than 450 thousand total visits and counting, and almost half of our home patients have conducted their clinic and physician visits via telemedicine over the last three months. In combination with our new connected health platform, PatientHub, we have made it even easier to be a home patient with modern tools to continue 24-hour support and improve remote patient monitoring.
Even with all this success in advancing home dialysis, we know transplant continues to be the first and best option for our patients. The Fresenius Medical Care Foundation has made generous donations to Donate Life America to develop the first-ever living donor registry and new donor testing kits, as well as supported the National Kidney Foundation’s Big Ask, Big Give transplant education program in our centers. And we are investing inside and outside our company for the future of kidney care. Fresenius Medical Care Ventures has made major investments to support early-stage companies on the frontlines of innovation, including our recent Series B round in eGenesis that is working to make more kidney transplants available using gene editing.
As the government prepares to launch the next step in their kidney health initiative, we must continue to work together to pave a brighter future for all patients with kidney failure. These patients are our north star. We fight for them every day. And we look forward to sharing more about the next step in this transformational journey.
Dr. Rob Kossmann is Executive Vice President and Chief Medical Officer for Fresenius Medical Care North America, and Joe Turk is President of Home and Critical Care Therapies for Fresenius Medical Care North America.