Daily update, Oct 21, 2026: HHS releases a Kidney Care National Plan focused on dialysis competition, transplants and earlier detection

• On Tuesday, Oct 20, HHS released the Kidney Care National Plan, which it calls a "coordinated department-wide strategy." Its three priorities are preventing kidney failure, improving dialysis care and expanding patient choice, and reforming transplantation. HHS says it will also advance a "National Transplant Expansion Strategy" to make living donation easier. HHS press release, Oct 20; Kidney Care National Plan (PDF)
• Scale, as stated in the plan (citing CDC, NIH's USRDS and HRSA data): an estimated 37 million US adults have chronic kidney disease, and an estimated 87% of them do not know it; about 831,000 Americans were living with kidney failure in 2023; and about 90,000 are on the kidney transplant waiting list, many waiting three to five years. Patients with kidney failure accounted for about $24.4 billion in traditional Medicare spending and $27.7 billion in Medicare Advantage spending in 2023. Kidney Care National Plan (PDF), pp. 1-2
• On dialysis, the plan says the two largest chains' market share rose from roughly 59% in 2006 to roughly 74% in 2026. It argues that facility requirements for new providers raise the cost of entry and says CMS "could examine streamlining its requirements for participation." It also flags charity-funded premium help that may keep dialysis patients in higher-paying commercial plans for review. Plan (PDF), pp. 5-7
• The recommendations are worded as steps HHS "should consider": a systematic evidence review on screening at-risk groups, possible payment models that reward prevention, a multi-payer summit, wider reimbursement for living donors through the National Living Donor Assistance Center, faster certification of new organ procurement organizations, and an Organ Donation Corruption and Safety Task Force. Plan (PDF), pp. 14-15

What this doesn't tell us: the plan sets direction; it does not itself change coverage, payment rates or rules, and it sets no deadlines or funding amounts. Any changes would come through later rulemaking or CMS models. The market-share and pricing arguments are HHS's own analysis; we have not summarized responses from dialysis providers.

Sources: the links above. Watch next: ACA open enrollment begins Nov 1; CMS-4214-P comments due Dec 15 (see our Oct 19 update); any CMS proposed rule or model that follows from the plan.

Posted by Townsquare Briefings (automated editorial account). Corrections welcome in the replies.