Northwest Kidney Centers responds to Advancing American Kidney Health Initiative

A statement from Joyce F. Jackson
CEO and President
Northwest Kidney Centers

President Trump today announced sweeping changes to the way kidney care is delivered and paid for in the United States. We applaud this unprecedented attention from the Chief Executive and top Cabinet officials toward the welfare of people with kidney disease.

As the eighth-largest dialysis provider in the country and the oldest in the world, Northwest Kidney Centers is pleased to have a spotlight on our field.

We know that details make a difference, so it will take time to fully assess the impact of the changes announced today. However, we heartily endorse the basic principles we heard discussed.

Based on our experience, education, home dialysis, technology improvements, kidney transplantation, and pay for performance all improve outcomes for patients. They not only help kidney patients feel better and enjoy life, they also save on health care expenses.

These emphases have been key to the way Northwest Kidney Centers has provided nonprofit kidney care for almost six decades:

Upstream care for chronic kidney disease. Kidney disease progresses over time, from minor damage to major loss of function and finally kidney failure, which requires dialysis or a transplant for survival. Intervening early can slow down the disease, perhaps avoiding kidney failure and the need for dialysis or a transplant. Managing high blood pressure and diabetes can sometimes even prevent kidney disease. At Northwest Kidney Centers, we have sponsored awareness and education programs with the American Diabetes Association, and we have our own customized set of free community classes for patients in various stages of kidney disease, including pre-dialysis. Our award-winning education programs have helped our patients and the wider community make better health choices.

Home dialysis. Northwest Kidney Centers has offered training and supervision since 1964 for people doing dialysis on their own, outside of a clinic. About 14 percent of our patients currently choose that option—the second highest percentage among the top 10 U.S. dialysis providers. Typically, people on home dialysis feel better and live longer than people treated in dialysis centers. Initial training is time-consuming and intensive, but overall cost to the health care system is less once patients are trained to do home dialysis.

Advances in dialysis technology. In 2008, Northwest Kidney Centers and UW Medicine collaborated to establish the Kidney Research Institute in Seattle; we later created the Center for Dialysis Innovation. We are pleased to see the Administration’s support for work in our region and elsewhere to develop portable, wearable and implantable kidney devices and other treatments that are easier on patients. We also look forward to expansion of the KidneyX competition to support promising innovations.

Kidney transplantation. This is the best option for the right patients. We work with our local organ procurement organization, LifeCenter Northwest, and Seattle’s three adult transplant centers to help our dialysis patients navigate the process to find a living kidney donor or get on the waitlist for a deceased donor kidney. Northwest Kidney Centers patients are 60 percent more likely than others across the country to get a kidney transplant. We welcome system improvements to make more transplants available.

Value-based purchasing, or pay for performance. This is a structure that rewards doctors, hospitals, medical groups, dialysis providers and others who take collective responsibility to improve patients’ health and still hold the line on overall health care costs by reducing inefficiency and coordinating care more closely. Since 2017 Northwest Kidney Centers has collaborated in a demonstration project to improve quality and lower costs; preliminary results are promising. We are happy to hear that new models will be introduced to expand value-based purchasing in kidney care.

I believe Northwest Kidney Centers—a nonprofit health care provider with a longstanding focus on what is best for patients—is well positioned to adapt to the changes the Administration is proposing. We welcome improvements that will result in optimal health, quality of life and independence for people with kidney disease across the country.