In a landscape littered with the corpses of well-meaning causes, the National Kidney Foundation of Michigan has quadrupled its staff in the past decade. What’s its secret? “We re-prioritized our core functions to focus a majority of our resources on preventing chronic kidney disease,” explains Dan Carney, the Ann Arbor-based foundation’s CEO and president. “Up until this point, direct patient services had been our key focus for about forty-five years.”

Prevention-oriented grants expanded the foundation’s funding base, and the shift in philosophy got a big boost two years ago with passage of the Affordable Care Act: the law created a $250 million fund to prevent, detect, and manage diseases before they become severe. “The Affordable Care Act is very focused on prevention of chronic disease and the importance of self-management,” says COO Linda Smith-Wheelock. With 70 percent of NKFM’s programming now focused on preventing chronic kidney disease, “the NKFM has a wonderful infrastructure to focus on in this arena.”

NKFM still provides care services, including Kids Camp for eight- to sixteen-year-olds on dialysis or who have had a kidney transplant. But most of its eighty-person staff now concentrates on health and wellness programming, including an exercise class, Enhance Fitness; Personal Action Toward Health (PATH), a prevention program that helps adults manage health issues like chronic kidney disease, hypertension, diabetes, and asthma; and the National Diabetes Prevention Program (NDPP), which offers sixteen one-hour sessions and monthly support meetings focused on lifestyle changes such as diet and exercise. Kids Interested in the Care of their Kidneys (KICK) and Kids and Kidneys outreach target school-age children and stress the importance of healthy eating and exercise in preventing chronic disease. All told, those programs reach 100,000 people a year.