The Hidden Disease Behind Billions in Employer Health Spending – Inside Sources

After 19 years, kidney health is back on Washington’s agenda. In March, the House Ways and Means Health Subcommittee, which oversees Medicare, the largest payer for kidney care, held its first dedicated kidney hearing since 2007. It was a welcome return of attention to a disease affecting tens of millions of Americans, and a timely reminder of how much we can accomplish when kidney care gets the focus it deserves.

American economic strength is directly tied to the strength of our workforce. As employers confront rising healthcare costs, labor shortages and growing rates of chronic illness, preventive care has never been more important.

One of the nation’s most common chronic diseases is largely overlooked: chronic kidney disease (CKD), which affects more than 35 million adults. This disease is altering America’s economic competitiveness, and because nine in 10 people with CKD don’t even know they have it, its economic effect often shows up without warning.

Early intervention is one of the most powerful tools employers have to improve health outcomes and reduce costs. The American Kidney Fund and National Alliance of Healthcare Purchaser Coalitions’ report, Healthy Workforces, Sustainable Futures: Why Employers Should Invest in Early Kidney Care, underscores how central early detection of kidney disease is to workforce readiness and healthcare cost containment.

The data tell a compelling story. Workers with moderate- to late-stage CKD make up only 1 percent of the U.S. workforce, yet they account for 8 percent of employer healthcare spending. That’s $107 billion in annual medical costs and $30 billion in lost productivity. These costs sit directly on employer balance sheets.

Earlier detection and management of CKD can meaningfully change the course of the disease and reduce treatment costs for millions of people at risk for CKD. And thankfully, we have the knowledge and tools to make a positive effect.

Advances in diagnostics, genetic testing and new therapies allow for CKD diagnosis and treatment far earlier than before. A simple urine test can cost as little as $10 and is often covered by insurance when requested. This routine screening is accessible and affordable for employers to promote. When workers receive timely screening and follow-up care, disease progression slows, quality of life improves, and employers see measurable savings.

Our analysis shows that if employers can help prevent progression to later stages of the disease, they could save up to $35 billion annually. Those savings don’t even include the additional value of higher productivity, better retention and greater workforce stability. Employers focusing on kidney health will have an immeasurably positive effect on employees’ longevity and quality of life.

CKD is the kind of high-cost, low-visibility risk that benefits employers when they take early, proactive action. Many at-risk employees, particularly those with diabetes or hypertension, may never receive the recommended kidney tests unless employers make detection and management a visible priority within their existing chronic disease strategy.

This is why employer action must be at the center of any national strategy to address kidney disease. Employers are the primary sponsors of health insurance in the United States. They have the reach and influence to encourage regular screenings, build awareness among workers about CKD risk factors, integrate kidney health into chronic disease programs, coordinate care more effectively, and cover innovative therapies that slow progression.

Importantly, none of this requires building programs from scratch. Early kidney care fits naturally into what employers are already doing for diabetes, hypertension and cardiovascular health. Simple steps can have a significant effect, such as encouraging employees to request an eGFR and uACR kidney test at their annual physical, and reducing or removing cost-sharing requirements for CKD screenings.

Employers can also benefit from setting expectations in health plan and vendor contracts, ensuring that disease management programs actually track kidney risk, support referrals to nephrology when needed, and flag employees who are missing key tests. Together, these evidence-based actions provide employers with a direct way to curb preventable illness and avoid the cascade of costs associated with late-stage kidney disease.

These actions are straightforward, evidence-based and achievable. They represent one of the clearest opportunities to reduce preventable illness before it becomes a crisis.

The benefits of employer leadership extend beyond the workplace. When fewer people progress from CKD to kidney failure, the entire health system sees significant savings. Treatment for end-stage renal disease averages nearly $81,000 per person each year. Even moderate improvements in early detection and prevention can shrink the number of people who reach kidney failure, resulting in substantial downstream savings.

By our estimates, reducing the number of people with CKD stages 3–5 by 25 percent could save Medicare $9 billion annually. For employers, these upstream improvements translate into fewer late-stage crises, fewer dialysis starts, and better long-term cost control — outcomes that benefit both employees and the organization.

At the American Kidney Fund, we believe early kidney care should be a standard component of every employer’s health strategy. Practical steps include improving employee awareness, aligning benefits to remove barriers to testing, incorporating kidney risk into diabetes and hypertension programs, and ensuring employees have access to therapies proven to slow disease progression.

We cannot allow kidney disease to continue its quiet advance. Our nation’s economic resilience depends on preventive care that keeps workers healthy and productive.

Early kidney care strengthens the workforce, reduces costs across the health system, and creates a more sustainable future for millions of workers.

Now is the time for employers to prioritize early kidney care.