Expanding Patient Choice Through the BETTER Kidney Care Act

By Pius Murray

October 9, 2020



Preserving patient choice is central to a successful treatment plan. Allowing patients to have control over the providers they see, the benefits they require, and what types of health care plans work best for them is one of the most surefire ways to guarantee that a patient’s treatments are working for them, and that those treatments will have long-term success.

This is especially true for patients like me with End-Stage Renal Disease (ESRD). In addition to dialysis treatments, ESRD patients also frequently need further treatments and take various medications for additional health issues, requiring several different health care providers. With such an involved health care plan, it is important that patients are able to choose what works best for them.

Like many ESRD patients, one of the most important decisions I have made is how and where to do my dialysis. Choosing between in-home and in-clinic dialysis is dependent on each patient’s home situation and support network. Furthermore, the clinic you choose to attend is also extremely important for patients. For example, I rely on transportation provided by the ADA to attend dialysis treatments, severely limiting the range of clinics available to me.

Thankfully, Congress recognized the importance of maintaining patient choice when they drafted the new BETTER Kidney Care Act. Currently being considered by Congress, the bill would improve access to coordinated care, and also provide for some benefits that are not available to ESRD patients through standard Medicare plans. In addition to this, the bill also includes several provisions to ensure that patient choice is not restricted by the care coordination services it provides.

For example, under the BETTER Kidney Care Act, Medicare beneficiaries would retain all of the benefits available to them through Medicare Parts A and B. Beyond that, patients would still have access to all Medicare providers, meaning they are free to choose the provider that best suits their needs. There are no preferred network provisions either that would potentially limit the choices available to patients or interfere with the relationship they have with their doctor. 

Since starting dialysis in 2013, I have experienced numerous health complications including issues with my thyroid, amputation, and heart surgery. Having the ability to run my health coordination decisions through my primary care doctor has streamlined my many treatment needs and ensured I am getting the best care possible, and it's an option that the BETTER Kidney Care Act could open to more patients across the U.S.

The bill also includes several safeguards to protect participating patients. For example, if for some reason patients wish to opt out, there are several time frames available for them to do so, such as within the first 90 days, if there is a change in their principal diagnosis, or if they elect to begin doing home dialysis.

Some have contended that the BETTER Kidney Care Act would hinder patient choice, but that is simply not true. Ultimately, denying the care coordination services available through the bill would be what truly limits patient choice. The BETTER Kidney Care Act offers solutions for problems faced by thousands of patients across the United States, and they deserve the choices offered to them through this bill.

Patient choice is paramount in guaranteeing successful treatment for ESRD patients. The BETTER Kidney Care Act will bring a host of new benefits for patients to the table, all while protecting their ability to choose what best suits them. For that reason, Congress should prioritize passing the BETTER Kidney Care Act and finally improve access to coordinated care for patients across the country. 


Pius Murray is a member of the Dialysis Patient Citizens Board of Directors.

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