# Plain Language Summary: BETTER Kidney Care Act

This bill creates a new way for Medicare to pay for and organize care for people with end-stage renal disease (kidney failure requiring dialysis). Instead of the current system where patients see multiple doctors and providers who don't always coordinate with each other, this bill sets up a demonstration program that brings together dialysis facilities, kidney doctors, and other healthcare providers into integrated care organizations. These organizations would work as a team to manage all aspects of a patient's care in one coordinated system.

The bill recognizes a real problem: people with kidney failure often have other serious health conditions like diabetes, high blood pressure, and heart disease. They typically see many different doctors each month and take numerous medications, but these providers often don't communicate well with each other. The bill also notes that kidney disease disproportionately affects Black Americans, Hispanic Americans, and Native Americans, and that these groups are less likely to receive home dialysis options. By creating these integrated care organizations, the goal is to help patients navigate the healthcare system more easily, better manage their medications and treatment plans, and get support for non-medical needs that affect their health—like transportation or financial assistance.

Under this program, participating organizations would receive a set payment from Medicare to cover all standard kidney disease care and related services. If an organization spends less than this payment amount, it must return the savings to patients in the form of additional benefits—similar to how Medicare Advantage plans work. The organizations must meet strict requirements, including having kidney doctors and patient advocates on their governing boards, maintaining adequate financial reserves, and ensuring they have enough patients to operate sustainably. Patients would voluntarily choose to participate, and they could still receive all the same Medicare benefits they currently get, plus additional services like transplant evaluation, palliative care, and hospice support.

BETTER Kidney Care Act

Blumenauer, Earl

Bringing Enhanced Treatments and Therapies to ESRD Recipients Kidney Care Act or the BETTER Kidney Care Act This bill requires the Centers for Medicare &amp; Medicaid Services (CMS) to establish a demonstration program for Medicare beneficiaries with end-stage renal disease (ESRD). Under the program, renal dialysis facilities, kidney disease specialists, physician practices, and other health care practitioners may form an organization that partners with certain health care entities to provide integrated care to beneficiaries with ESRD. Such care must include all covered Medicare benefits as well as transition services for transplantations, palliative care, and hospice. Each organization must have a minimum number or percentage of participating beneficiaries (350 or 60% of beneficiaries served at the organization's facilities) and must also comply with certain fiscal, governance, and quality of care requirements. Additionally, the Government Accountability Office must study certain data that is reported to the CMS regarding pediatric dialysis care, as well as the effects of race-based corrections to a specified kidney function test on referrals of ESRD patients for transplant evaluations.