End Stage Renal Disease and Kidney Transplantation in the Era of Healthcare Reform

Abstract

Over the course of the last half century, a significant array of legislative initiatives has been launched to reform America's healthcare system. Successful reforms, the most significant of which include Medicare's End Stage Renal Disease Program Amendments, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, the Health Care and Education Reconciliation Act of 2010, and the Patient Protection and Affordable Care Act of 2010, have been taken to streamline coverage and delivery systems of health care programs. Collectively, these initiatives have helped improve access to kidney transplantation, alleviate costs of dialysis and medications, increase coverage for uninsured patients in the post-transplant stage, and introduce novel healthcare delivery systems for end stage renal disease patients. However, these reforms may also impose potential challenges for organ transplantation (by exacerbating the organ shortage crisis or placing significant financial pressure on transplant centers). The following paper analyzes both the advantages and setbacks of recent healthcare reforms in Medicare, Medicaid, and Accountable Care Organizations in the context of end stage renal disease.