, 10 tweets, 3 min read Read on Twitter
SInce @realDonaldTrump signed the executive order on #AdvancingKidneyHealth I have been receiving and reading a lot of push back from people who do not like his politics, find his administration abhorrent, and feel that the kidney community should not endorse these reforms 1/9
Guy's it's time for some game theory. The policies that were enacted by EO have been advocated by the RPA, NKF, and ASN for the last 10 years. The payment models that are being adopted by medicare are directly from the RPA. 2/9
Do people opposed to this administration think that all lobbying should have stopped in 2016? Should we abandon contacts and progress until a new administration is in place? Much of the work was done with career government employees with no connection to the administration. 3/9
The answer is of course, the work on improving the system of kidney care in the US should not depend on the current administration but should alway move forward. The surprise came when HHS said yes and the president agreed to sign the EO. 4/9
Some people do not trust this administration, and the president does have a sketchy track record on following through (See axios.com/donald-trump-c… and washingtonpost.com/business/white… just this week) but until it fails this is the direction Medicare is going. 5/9
This is nephrologies opportunity to lead medicine to where all fields need to go. We need to stop sucking from the fee for service teat and provide value for our patients. This is a lot of what Obama set in motion nearly a decade ago 6/9
and all indications were that Trump was going to slow that transition. Except, apparently not in nephrology, where fee for values starts in about 6 months! 7/9
Another concern is that trump is fighting the ACA which will make delivering CKD care harder so this is really at cross purposes. Yes, this is true. But it doesn't negate the value we are getting from the Advancing Kidney Health initiative and... 8/9
rejecting this initiative will not save the ACA.

The obscene incentives to put patients on, and keep them on dialysis are being tossed. The new incentives focus on slowing progression, providing dialysis at home and to increasing transplants.

What side are you on? 9/9
If you made it to the end of this #MedThread give @ASNAdvocacy a follow. They worked closely with the peeps at Medicare to make this happen.
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