Trump wants to stem the tide of kidney disease

Note: Current through June 30, 2019; Data: United Network for Organ Sharing; Chart: Chris Canipe/Axios

President Trump signed an executive order yesterday modernizing kidney disease care for the first time in decades, a move that could reduce spending and improve treatment for one of the country's most pervasive illnesses.

Why it matters: This could be a big deal for the 37 million Americans suffering from chronic kidney disease, including 726,000 with kidney failure.

The big picture: The executive order requires Medicare to test different payment models encouraging preventive kidney care, home dialysis (versus facility-based dialysis) and kidney transplants.

  • The administration will also push for the development of artificial kidneys and speed up the kidney matching process so that more people can get transplants.
  • Almost 100,000 Americans are waiting for a kidney transplant, by far the most common organ transplant, and more than 100,000 begin dialysis each year.

The administration's goals are ambitious: It wants to reduce the number of patients with kidney failure by 25% by 2030, have 80% of patients who do develop it in 2025 either receive home dialysis or a kidney transplant, and double the number of kidneys available for transplant by 2030.

What they're saying: Encouraging home dialysis would obviously shake up the business models of dialysis clinic operators, namely the duopoly of DaVita and Fresenius. But they've already been moving in this direction, said Dan Mendelson, founder of Avalere Health.

  • "Home dialysis isn’t a full replacement for traditional dialysis, and the large chains have been preparing for this evolution for years," he said.

The bottom line: The focus on home dialysis and prevention are good for patients, and the executive order "could also reduce federal cost somewhat if implemented properly – but we need more detail to really assess that," Mendelson said.

Go deeper: The growing toll of kidney disease

Additional Stories

Alexander Vindman and Jennifer Williams testify in impeachment hearing

Lt. Col. Alexander Vindman, the National Security Council's top Ukraine expert, and Jennifer Williams, an aide to Vice President Pence, are testifying Tuesday morning as the House kicks off its second week of impeachment hearings.

Why it matters: This morning's hearing is the first time we'll hear publicly from witnesses who listened to the July 25 call between President Trump and Ukrainian President Volodymyr Zelensky that lies at the heart of the impeachment inquiry.

This post will be updated with new developments as the hearing continues.

A Teflon earnings season

Illustration: Sarah Grillo/Axios

With Q3 earnings season nearly over, investors are applauding, even cheering companies that fall short of expectations or signal next quarter won't be as rosy as previously thought.

Why it matters: Investors' renewed optimism that's pushed stock prices to all-time highs is giving businesses more leeway than in the past.

Trump Inc. leaks on itself

Illustration: Sarah Grillo/Axios

As televised impeachment hearings roll into Week 2, one surprise has been how many of the Trump team's wounds have been self-inflicted, because of his allies' curious habit of leaking on themselves.

Why it matters: The leaks and revelations have thrown President Trump into a constant state of defensiveness, and turned a growing number of Republicans into frustrated, sometimes bewildered, defenders.

Pro-Trump group finds swing voters are unconvinced on impeachment

Photo: Mandel Ngan/AFP via Getty Images

The pro-Trump group America First says focus groups show that suburban swing voters — even some who strongly dislike President Trump — remain skeptical about impeachment.

Why it matters: These early findings will help shape Republican messaging about impeachment and Trump's top Democratic rivals.

Health industry expects little change from heart study

How a stent works. Photo: BSIP/Universal Images Group via Getty Images

A new federal study said stents and bypass surgery are no more effective than drugs for treating blocked arteries, but the health care industry and its investors aren't banking on major changes to heart care as a result.

The big picture: Placing stents and performing bypasses are two of the most common operating room procedures. Science continues to say we don't need to be doing them so often, but overhauling that standard of care isn't easy — in part because hospitals and device makers make a lot of money from them.

Las Vegas mass shooting claims 59th victim, two years on

Tags outside Las Vegas Village bearing the names of those killed in the 2017 massacre. Photo: Ethan Miller/Getty Images

California woman Kimberly Gervais has become the 59th person to die from injuries sustained in the Las Vegas shooting massacre, a coroner confirmed in a statement on Monday.

Why it matters: The shooting at the Route 91 Harvest Festival, which occurred when a gunman opened fire from his Mandalay Bay hotel room before killing himself, is the deadliest in modern U.S. history.

Protests paralyze Hong Kong: What you need to know

Hong Kong riot police fire teargas and rubber bullets as protesters attempt to leave The Hong Kong Poytechnic University on Monday.

Authorities say hundreds of student protesters have been arrested at Hong Kong Polytechnic University, but about 100 were defying police orders to surrender as the standoff entered a third day on Tuesday, AP reports.

The latest: The city's leader Carrie Lam said 600 demonstrators had left the campus, including 200 who are younger than 18, AP notes. Dozens of activists escaped from the building by "shimmying down plastic hosing from a bridge and fleeing on waiting motorbikes as the police fired projectiles," per Reuters.

California won't buy from automakers who side with Trump on emissions

Traffic backs up at the San Francisco-Oakland Bay Bridge toll plaza along Interstate 80 in July. Photo: Justin Sullivan/Getty Images

California confirmed Monday that it won't buy new government vehicles from automakers who backed President Trump in his carbon emissions war with the state, the New York Times reports. GM, Fiat Chrysler and Toyota are among those set to be affected by the move.

Driving the news: The three big automakers and others announced in October that they were joining the Trump administration's side in litigation over its move to stop California from imposing emissions rules and, by proxy, mileage requirements that are tougher than federal standards, per Axios' Ben Geman.

Read more at Axios
© Copyright Axios 2019