The Centers for Medicare & Medicaid Services announced a rate hike in late October that will significantly increase the amount Medicare pays to dialysis centers. For anyone concerned with health care costs, this news was the latest reminder of the urgent need to overhaul the ways we detect and treat costly chronic conditions like chronic kidney disease — a silent killer that costs Medicare over $120 billion annually.
If diagnosed early, CKD is treatable. Unfortunately, it often goes undetected until it is too late. In America, 1 in 3 adults are at risk of developing CKD. Already, 1 in 7 Americans have early-stage kidney failure but are mostly unaware of the threat: Roughly 50 percent of CKD cases are discovered in emergency room settings. By that point, the disease is likely to be irreversible and expensive treatments like dialysis are largely unavoidable. In 2019, end stage renal disease cost the Medicare system a staggering $12.9 billion on dialysis treatments alone.
These price hikes, and the soaring cost of treating CKD in general, are avoidable. New technologies, already deployed nationally in Europe, can improve patient care and reduce costs by eliminating systemic barriers that prevent people from getting key diagnostic tests earlier and more efficiently.
Tragically, much of this cost — and the human suffering that accompanies it — is avoidable. While doctors typically recommend a simple annual urine test that enable early detection of kidney disease, 80 percent of Americans at risk for the disease don’t take the test.
Some struggle to schedule a test around their work or family care responsibilities. For roughly 3.6 million people in the United States, a lack of access to reliable and affordable transportation limits their medical care options. Add to that the inability — or unwillingness — of many to visit medical providers during the pandemic and you have millions of people missing simple tests that could have a major impact on their quality of life.
Simply put, our health care system is being crushed by the burden of treating conditions we should be able to catch earlier and treat more effectively and efficiently.
Believe it or not, if you are one of the millions of people who gets your news from your smartphone, the device in your hand right now may also be the key to solving this problem. The camera technology in smartphones has advanced so much in recent years that you can use it to perform an ACR test in a matter of minutes and get the results just as quickly.
In the United Kingdom, the National Health Service has opted to shift ACR testing for patients at risk to the smartphone. The first stage of this national effort focuses on 600,000 people with diabetes and has already delivered improved outcomes. When given the option to test at home using a smartphone camera, test adherence increased from 0 percent to 50 percent among patients who had not done a urine test for kidney disease in the previous year. In the United States, health plans can more than double their current adherence rates.
The same technology can apply to other chronic conditions as well. As we mark National Diabetes Awareness month in November, it’s a good time to talk about how to best monitor and treat the scourge of diabetic ulcers and other chronic wounds that afflict countless patients.
The same smartphone camera technology can be used to monitor the condition of these wounds, improving the quality of the care patients receive while reducing burdens on the health care system.
Eliminating barriers to diagnostic tests leads to better patient care. It improves quality of life for patients by averting the need for expensive treatments like dialysis.
It’s a win for everyone and one way that technology can help overhaul our health care system. The alternative — continued rising costs of dialysis treatment — leaves too many people behind.
Yonatan Adiri is the founder and CEO of Healthy.io, the global leader providing platforms and services that transform the smartphone camera into a medical device.
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