For-profit dialysis provider charges private insurers 4 times more than government payers

May 14, 2019

FINDINGS Private insurers covering people receiving treatment for dialysis paid four times more than government insurance programs such as Medicare paid for the same service. The study found that government programs paid, on average, $248 per dialysis session, compared with $1,041 per session for people with private insurance.


Medicare covers treatment for all dialysis patients, not just those 65 and older. Medicare pays a fixed rate for dialysis care. However, if patients have private insurance, such as through their employer, the dialysis treatment is paid by the private insurer instead of Medicare. Unlike Medicare, private insurers must negotiate with dialysis clinics on the prices they will pay.

Two for-profit companies, DaVita and Fresenius Medical Care, control about 75 percent of the U.S. dialysis market. DaVita alone controls 37 percent of the market, operating more than 2,500 U.S. clinics, the researchers say.


The researchers reviewed DaVita's annual financial statements from January 2010 to December 2017 filed with the U.S. Securities and Exchange Commission. They limited their scrutiny to the company's "dialysis and related lab services" segment, which includes outpatient hemodialysis, peritoneal dialysis and inpatient dialysis.

The study has some limitations. For instance, some private insurers may pay more or less than the averages listed above, and the results may not apply to for-profit or not-for-profit dialysis providers other than DaVita.


Previous research has shown that the prices paid for medical care in the United States are higher than all other developed nations. This study corroborates these findings in the dialysis market and could lead to policies that reduce the prices paid, in particular by private insurers.


The authors are Dr. Christopher Childers, Dr. Jill Dworsky and Dr. Melinda Maggard-Gibbons of the department of surgery, David Geffen School of Medicine at UCLA; and Gerald Kominski of the UCLA Center for Health Policy Research in the UCLA Fielding School of Public Health.


The study is published in JAMA Internal Medicine.


The Agency for Healthcare Research and Quality in the Department of Health and Human Services funded this study.
Enrique Rivero | May 13, 2019

University of California - Los Angeles Health Sciences

Related Dialysis Articles from Brightsurf:

Immediate dialysis no better than wait-until-necessary approach, researchers find
In the largest international study of its kind, researchers at the University of Alberta and Toronto's St.

Predictors of 5-year mortality in young dialysis patients
The analysis published in NDT [1] evaluated for the first time the association of a large number of demographic, HD treatment and laboratory variables with mortality in patients on chronic hemodialysis treatment since childhood.

COVID-19 mortality alarmingly high in dialysis patients
Analysis of a Spanish experience shows that COVID-19 is frequent in hemodialysis patients, who appear to be at risk for worse outcome.

Survival following switch from urgent in-center hemodialysis to home dialysis
Few patients who start urgent and unplanned dialysis in clinical centers switch to home dialysis.

Is ownership of dialysis facilities associated with access to kidney transplants?
An analysis that included data for nearly 1.5 million patients with end-stage kidney disease looked at whether ownership of dialysis facilities was associated with patients' access to kidney transplants.

At-home dialysis improves quality of life
The rate of people starting voluntary at-home peritoneal dialysis rose from 15% to 34% over 10 years at Kaiser Permanente in Northern California, providing a convenient and safe way to manage advanced-stage kidney disease compared with center-based hemodialysis, according to research published today in JAMA Internal Medicine.

Hydration sensor could improve dialysis
Researchers from MIT and Massachusetts General Hospital have now developed a portable sensor that can accurately measure patients' hydration levels using a technique known as nuclear magnetic resonance (NMR) relaxometry.

Uncovering possible role of polyphosphate in dialysis-related amyloidosis
Researchers from Osaka University found that the low concentrations of the naturally occurring biopolymer, polyphosphate (polyP), induces amyloid formation from β2 microglobulin under both acidic and neutral conditions but by different mechanisms.

Study compares dialysis reimbursement around the globe
Dialysis reimbursement policies in most countries are focused on conventional in-center hemodialysis, although home hemodialysis and peritoneal dialysis might contribute to quality of life and cost savings.

Elderly patients on dialysis have a high risk of dementia
Older kidney disease patients who are sick enough to require the blood-filtering treatment known as dialysis are at high risk of dementia, including Alzheimer's disease, according to a study led by scientists at Johns Hopkins Bloomberg School of Public Health.

Read More: Dialysis News and Dialysis Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to