Washington, D.C. (WVDN) – Today, Congresswoman Carol Miller (R-WV) participated in a Ways and Means Health Subcommittee hearing titled “Modernizing American Health Care: Creating Healthy Options and Better Incentives” to examine opportunities to incentivize healthier living and combat chronic diseases.
Congresswoman Miller began by highlighting the health and financial challenges West Virginians and the health care system face due to chronic diseases, as well as the significance screening can have on detecting and treating serious illnesses within patients.
“1.2 million people in West Virginia have at least one chronic disease, and 527,000 people have multiple chronic diseases. In a state of only 1.7 million people, these numbers are staggering and concerning. Not only are these numbers alarming from a public health perspective, but they also worry me from a fiscal perspective. Patients with multiple chronic diseases cost the health care system more money to treat – and cost West Virginia more than $10 billion annually in medical costs. The most commonsense way to help combat the chronic disease epidemic is through education, screening, and prevention. I specifically focus much of my work on kidney disease, and I recently became Co-Chair of the Congressional Kidney Caucus with fellow Ways and Means Member Suzan DelBene. Chronic Kidney Disease is also known as the ‘silent killer’ because it can progress for years without symptoms. If left unmanaged, chronic kidney disease will progress into End Stage Renal Disease. The disease can only be managed with regular dialysis or a transplant. Dialysis is extremely expensive for the federal government and very taxing for patients. ESRD affects only 1% of Medicare beneficiaries, but accounts for 7% of Medicare spending. Managing dialysis can be particularly difficult for patients in rural areas. Finding transportation to the nearest dialysis facility and spending hours on travel and treatment is very burdensome for patients that live in rural communities. While increasing access to services such as home dialysis can help patients manage their disease, life can be made much easier if a physician or nephrologist can identify a patient with chronic kidney disease early on,” said Congresswoman Miller.
Congresswoman Miller asked Dr. Jay Carlson, an OBGYN and Clinical Chair at Mercy Clinical Research, to explain the benefits of early screening.
“Dr. Carlson, you know firsthand that early screening can reduce costs and improve outcomes for patients. Can you speak about how early screening can affect long-term health outcomes for patients with chronic diseases?” asked Congresswoman Miller.
“There’s great evidence that says early diagnosis, early intervention, is going to have improved outcomes at less cost. Chronic kidney disease is present in about 15% of adults and about a quarter of those then also have a family history and our next gen sequencing, these genomics assays are widely utilized for pediatric nephrology but are rarely used in adult nephrology. I think that for chronic kidney disease in particular that there should be a migration, a broader adaptation of some of the genomic assays that would be available for those patients to identify them and allow that earlier intervention,” responded Dr. Carlson.
Congresswoman Miller highlighted a bipartisan bill she introduced to help patients with kidney disease and addressed how cancer is impacting rural communities. She then asked Dr. Carlson to explain his thoughts as to why there is an increase in cancer among rural Americans.
“I have worked on legislation with Congresswoman Terri Sewell called the Chronic Kidney Disease Improvement in Research and Treatment Act. It expands the Medicare annual wellness benefit to include kidney disease screening. It also increases access to the Medicare kidney disease education benefit. This will enable physicians to teach patients about managing their disease and any comorbidities they may have. A recent study shows that compared to urban areas, rural communities have higher rates of cancer, higher rates of late-stage cancer diagnoses, and higher cancer deaths. The urban-rural gap isn’t getting better – in fact, it’s been steadily widening over the last decade. Rural areas also generally have lower reported rates of cancer screenings for colorectal, breast, and cervical cancer. Dr. Carlson – given your experience, can you tell us more about why rural communities are struggling with cancer?” asked Congresswoman Miller.
“A large footprint for Mercy is in that rural community. There are a lot of barriers, one of them being transportation-just to get in that makes it a challenge. The rural community sometimes can be uneducated, so we appreciate the work that you’ve done in educating patients. I think some of it’s also trying to figure out how to incentivize those patients regardless of where they live or their financial situation that we pushed them to get in and some of the predictive algorithm work that we’ve done, we identify patients and if you knew that your risk for colon cancer was 10 times higher than the average patient, it might push you to get the bowel prep and a colonoscopy done. So, these types of things, what I think in addition to the other incentives that you’ve listed will help incentivize the patient to take greater control of their own care,” responded Dr. Carlson.
