As part of its commitment to advancing health equity by removing unintentional bias from health care, UnitedHealth Group is supporting a new, joint decision by the National Kidney Foundation and the American Society of Nephrology that eliminates race from a key kidney-function diagnostic equation.
Both kidney care professional organizations recommended using a new “eGFR 2021 CKD EPI creatinine equation” that estimates kidney function without using race. An accurate eGFR (estimated glomerular filtration rate) is key to managing kidney disease, which affects as many as 37 million American adults. Some prior kidney function calculations included race in their estimates, and the decision by the NKF and ASN means race is no longer an acceptable factor to consider when accurately estimating GFR.
Medical evidence demonstrates that the inclusion of race can create barriers to care in the case of eGFR. This work instead helps reduce errors that might be unintentionally fostered by using race when there is no scientific need to do so.
“We are absolutely committed to ensuring that patients and members receive the most clinically sound care possible, and we support efforts by the NKF and ASN to address the adverse impact of under-recognition of kidney disease in African American patients.”
– Dr. Richard Migliori, Chief Medical Officer, UnitedHealth Group
UnitedHealth Group’s decision to support the new race-blind kidney care equation is part of a larger effort by the organization’s Addressing Clinical Bias Working Group, led by Dr. Aaron Cohen, Chief Medical Officer, Clinical Services Operations, Optum and Dr. Jessica Dale, Associate Director of Health Equity, UnitedHealth Group. The working group reviews clinical algorithms that may drive bias in education, influence provider decision making, and potentially widen care gaps and racial health disparities.
“The use of race-based clinical algorithm calculators may contribute to health disparities and as an organization we are committed to using our analytic capabilities to identify and address areas of race-related health inequity,”
– U. Michael Currie, Chief Health Equity Officer, UnitedHealth Group
The working group’s research supports the belief that race-based equations should be replaced by an approach that is more accurate, inclusive and standardized across laboratories in the United States.
The research by the NKF, the ASN and UnitedHealth Group also aligns with recent work performed by the American Medical Association that defines race as a social construct with no biological basis.
UnitedHealth Group is also committed to ongoing internal efforts to educate its clinicians and peers about the importance of appropriately considering race, without bias, through an objective scientific and clinical lens.
“We support the continuous evaluation and development of standards and best practices for the use of race in research, education and clinical practice with a focus on race-conscious health care rather than race-based medicine.”
– Dr. Margaret-Mary Wilson, Associate Chief Medical Officer, UnitedHealth Group
Advancing Health Equity
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