Enhancing kidney care in community health centers (ENRICH)

The National Institute for Minority Health and Health Disparities awarded the University of Washington $2.938 million on September 3, 2026, under the Minority Health and Health Disparities Research program (CFDA 93.307).

The award funds the ENRICH (Enhancing Kidney Care in Community Health Centers) project, a mixed-methods research initiative to improve kidney disease management in federally qualified health centers, rural health clinics, and other community-based providers serving high-risk populations. The project leverages OCHIN Inc., the nation's largest network of community health centers, which collectively serve over 8 million patients across 2,400 clinics in 43 states. Research objectives include identifying health center factors and services associated with the highest implementation of guideline-based chronic kidney disease care and the lowest risk of adverse kidney outcomes in non-dialysis-dependent patients, and identifying opportunities to improve care delivery and efficiency among vulnerable populations currently underrepresented in kidney disease research.

The project period runs from September 3, 2026, through July 31, 2030. Performance takes place at the University of Washington in Seattle, Washington. The University of Washington's Office of Sponsored Programs serves as the prime recipient and administrative gateway for the award.

Abstract

Chronic kidney disease affects over 35 million people in the united states, cost medicare over $130 billion annually, and contributes to premature death and disability. Notably, the risk of kidney failure - most often from treatable conditions such as diabetes and hypertension - is concentrated among individuals who are low- income, underinsured, or from rural or under-resourced communities. Despite decades of elevated kidney failure risk in these populations and the availability of interventions to prevent kidney disease progression, high rates of disease progression and unplanned dialysis and low rates of pre-emptive kidney transplant persist. Prior studies of non-dialysis dependent kidney disease have largely excluded populations at highest risk for kidney failure because they do not routinely receive care at urban, specialized centers. Instead many of these patients rely on community health centers − a patchwork of federally qualified health centers, rural health clinics, and other programs that collectively care for over 30 million patients annually. To date, the absence of large-scale data from community health centers has left many high-risk, high-needs patients with kidney disease invisible to health systems, researchers, and policymakers unless they survive to kidney failure, when most will qualify for medicare's $45 billion end-stage renal disease program. This proposal will leverage innovative mixed methods and the nation's largest network of community health centers (ochin INC., 8+ million patients, 2400+ clinics in 43 states) to identify opportunities to improve the delivery and efficiency of care to patients with kidney disease. We aim to: (1) determine the health center factors and services associated with the highest implementation of guideline-based practice and lowest risk of adverse kidney outcomes in non-dialysis dependent chronic kidney disease; and (2) identify the patient, provider and health center pathways that contribute to outcomes of non-dialysis dependent kidney disease in community health settings. Our work aligns with the HHS advancing american kidney health initiative - to reduce the costly burden of kidney disease. Together, this work will deliver immediately actionable data to advance kidney care in america's community health centers. Ochin's national scope and integrated electronic health records network can facilitate rapid changes to clinical practice and test strategies for enhancing kidney care delivery to patients in community health settings.