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Medicare Incentivizes Early CKD Stage 3 Diagnosis

By Susan Eymann, MS20 Apr 2018

Chronic kidney disease (CKD) is the slow break down of our kidneys' ability to filter fluid and waste products from our blood. The disease afflicts more than 2 million persons

CKD-Stage-3-1worldwide and more than 650,000 persons in the United States. Kidneys don’t typically fail all at once, but their function usually declines slowly over a period of years. Frequently, CKD does not present symptoms in its early stages so it is often called “a silent killer.”

To identify and treat each level of kidney disease, the National Kidney Foundation (NKF) has divided chronic kidney disease into five stages. The focus during the first four stages is on preserving kidney function for as long as possible. During the final stage, 5, known as end-stage renal disease (ESRD), treatments such as hemodialysis or kidney transplantation are necessary to remain alive.

Now Medicare has good news for CKD sufferers. At the beginning of 2019, the Centers for Medicare & Medicaid Services (CMS) will incentivize physicians to assess and properly diagnose the presence of Stage 3 CKD earlier by increasing its reimbursement to privately operated Medicare Advantage health plans for a CKD Stage 3 diagnosis. It currently increases payments for patients who have Stage 4 or Stage 5 CKD. By extending this payment allowance to Stage 3 CKD patients, Medicare anticipates that more patients will be diagnosed and treated earlier, thereby improving and prolonging their quality of life.

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