Sep 25, 2026 · 15 min · 12 segments
Editor's Summary by Linda Brubaker, MD, and Preeti Malani, MD, MSJ, Deputy Editors of JAMA, the Journal of the American Medical Association, for articles published from…
Preeti MalaniHostMore than 500,000 people in the United States are on maintenance dialysis to treat kidney failure.
And for those who are eligible, kidney transplant can improve both survival and quality of life.
In 2021, the 21st Century Cures Act enabled Medicare beneficiaries with end-stage kidney disease to enroll in private Medicare Advantage plans, and this has potential implications for access to kidney transplant.
In an original investigation, Dr. Shah and colleagues characterized differences in transplant access between traditional Medicare and Medicare Advantage in more than 630,000 Medicare beneficiaries with end-stage kidney disease from 2021 through 2023.
The authors report important gaps in transplant rates, which were lower in Medicare Advantage, 2.5 compared with 4.6 per 1,000-person months.
New waitlisting rates were also lower, 3 compared with 4.6 per 1,000-person months.
Even among patients already waitlisted or newly waitlisted, transplant rates remained lower in Medicare Advantage, 16.6 versus 20.9 per 1,000-person months.
The authors say these findings support closer policy oversight as Medicare Advantage enrollment continues to grow.
More than 500,000 people in the United States are on maintenance dialysis to treat kidney failure.
And for those who are eligible, kidney transplant can improve both survival and quality of life.
In 2021, the 21st Century Cures Act enabled Medicare beneficiaries with end-stage kidney disease to enroll in private Medicare Advantage plans, and this has potential implications for access to kidney transplant.
In an original investigation, Dr. Shah and colleagues characterized differences in transplant access between traditional Medicare and Medicare Advantage in more than 630,000 Medicare beneficiaries with end-stage kidney disease from 2021 through 2023.
The authors report important gaps in transplant rates, which were lower in Medicare Advantage, 2.5 compared with 4.6 per 1,000-person months.
New waitlisting rates were also lower, 3 compared with 4.6 per 1,000-person months.
Even among patients already waitlisted or newly waitlisted, transplant rates remained lower in Medicare Advantage, 16.6 versus 20.9 per 1,000-person months.
The authors say these findings support closer policy oversight as Medicare Advantage enrollment continues to grow.
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