HR 4661

                              SECOND REGULAR SESSION
        HOUSE RESOLUTION NO. 4661
                         103RD GENERAL ASSEMBLY
                         INTRODUCED BY REPRESENTATIVE HRUZA.
7534H.01I  JOSEPH ENGLER, Chief Clerk
       WHEREAS, an estimated 35.5 million adults in the United States, or fifteen percent,
 2 have chronic kidney disease, and nine out of ten adults with kidney disease do not know they
 3 have it; and
4
5WHEREAS, cardiovascular disease is the leading cause of death in the United States,
 6 accounting for one in every three deaths, or a death due to cardiovascular disease every thirty-
 7 four seconds; and
8
9WHEREAS, cardiovascular-kidney-metabolic syndrome is defined as a health
10 disorder due to connections among heart disease, kidney disease, diabetes, and obesity
11 leading to poor health outcomes; and
12
13WHEREAS, chronic kidney disease significantly increases the risk of heart attack,
14 stroke, and heart failure, and cardiovascular disease is the leading cause of death for
15 individuals with kidney disease; and
16
17WHEREAS, Medicare spends about $130 billion on kidney disease, with forty-five
18 percent of dialysis patients being dually eligible for Medicare and Medicaid; and
19
20WHEREAS, cardiovascular disease cost about $417.9 billion in health care services,
21 medicines, and loss of productivity due to death in 2020 and 2021 alone; and
22
23WHEREAS, in 2023, Medicaid per-person per-year spending was four hundred
24 twenty-five percent higher for adults under sixty-five years of age with chronic kidney
25 disease and heart failure ($28,534) compared to those without chronic kidney disease or heart
26 failure ($5,440), and dual-eligible spending was one hundred forty-six percent higher for
27 adults sixty-five years of age or older with chronic kidney disease and heart failure ($56,045)
28 compared to those without chronic kidney disease or heart failure ($22,803); and
29
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30WHEREAS, geographic barriers and limited access to specialty care can delay
31 diagnosis of chronic kidney disease in rural and remote communities; and
32
33WHEREAS, targeted screening can support earlier identification and referral,
34 particularly in primary care settings; and
35
36WHEREAS, there are cost-effective, easily accessible blood and urine tests to
37 diagnose chronic kidney disease; and
38
39WHEREAS, failing to identify the presence of chronic kidney disease or
40 cardiovascular disease can lead to adverse health effects for patients and increased costs to
41 the health care system; and
42
43WHEREAS, early identification of kidney disease through routine screening,
44 particularly for individuals with hypertension, diabetes, cardiovascular disease, or a family
45 history of kidney disease, can dramatically slow disease progression and reduce
46 cardiovascular complications; and
47
48WHEREAS, community-based education, culturally appropriate care, and
49 coordinated management of kidney and heart health have been shown to improve
50 outcomes, reduce hospitalizations, and lower long-term health care costs:
51
52NOW THEREFORE BE IT RESOLVED that we, the members of the Missouri
53 House of Representatives, One Hundred Third General Assembly, Second Regular Session,
54 hereby encourage:
55
56(1) Continued evaluation of targeted screening approaches for at-risk populations,
57 particularly in rural and underserved areas of the state, to identify individuals with chronic
58 kidney disease;
59
60(2) The Missouri Department of Health and Senior Services to consider public-private
61 collaborations to educate patients and health care providers on the importance of urine
62 albumin-to-creatinine ratio screening to help uncover signs of early, and possibly treatable,
63 kidney damage that other routine screenings may miss; and
64
65(3) The Centers for Medicare and Medicaid Services to update recommendations or
66 guidelines to increase access to complete cardiovascular-kidney screening for at-risk
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67 Medicare and Medicaid populations and ensure that screening and management translate into
68 improved clinical care through robust quality measurement and incentives.
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