Providers take issue with Trump’s budget

A White House proposal to make up to 17,000 kidneys available for transplant could mean good news for an estimated 70,000 nursing home residents diagnosed with end-stage renal disease.

The Trump administration proposal, which sources said he planned to unveil Wednesday morning, is also meant to reduce overall costs to the healthcare system. Medicare and Medicaid funding covers much of the cost of dialysis needed for ESRD residents and transplantation.

The administration wants to discuss fewer discards of less-than-perfect organs, encourage more live transplants and require nonprofits that collect organs to increase their quality, according to the Washington Post. Politico first reported on Trump’s plans, which include moving more kidney treatment to a home-based care setting.

More than 113,000 people in the United States are waiting for organs, with kidneys in the most need. The administration’s stated goal is to keep people with kidney disease off dialysis longer. Shares of DaVita Inc., Fresenius Medical Care AG and American Renal Associates Holdings Inc. all slid in Tuesday trading. 

Additionally, providers may worry about frail seniors managing their kidney disease upon discharge from a nursing home, or delay entering a skilled facility if they feel they have other home-based options. Part of the vision of the White House is to explore at-home dialysis for patients, with Health and Human Services Secretary Alex Azar saying this spring that earlier detection of kidney disease could lead to more in-home dialysis. Currently, only about 12% start dialysis treatment at home.