How many dialysis clinics in the us

Maybe, she says she began thinking, her family would be better off without her. A social worker at her dialysis center noticed her low moods and increasing despondence, and Karabasz eventually confessed everything. Founded in , the AKF began as a small group of people raising money for a friend who needed help paying for dialysis.

Karabasz easily met those requirements and began receiving help almost immediately. To her, it changed everything. Thank God that that help was available. Karabasz is one of more than 80, low-income Americans — 3, of whom are in California — who receive help from the American Kidney Fund each year. On the surface, the arrangement seems copacetic: a charity helping low-income chronic disease patients receive life-saving treatment.

But both lawsuits and the California legislation have challenged this rosy view of the Fund and its work. In the s, when the AKF was founded, outpatient dialysis was fairly new and the industry was small. Medicare coverage expanded the number of people who could afford dialysis, and increases in the prevalence of diabetes and hypertension, along with an aging population, meant that the number of people who needed dialysis also rose. At first, many providers were small and independently owned.

Beginning in the late s, two early leaders in dialysis, DaVita and Fresenius, began to buy out smaller clinics. By gobbling up individual clinics, one by one, the companies could avoid federal oversight of corporate mergers, which generally only kick in when an acquisition is valued over a certain amount. The problem, points out University of Chicago economist Thomas Wollmann, is that dialysis clinics serve a local clientele.

Wollmann says he knows of one area in Texas, for example, that has two dialysis clinics right next to each other but nothing else for 60 miles in any direction. According to a recent National Bureau of Economic Research working paper he authored, of the 4, facility acquisitions dialysis providers proposed between and , about half were exempt from reporting. As large chains, DaVita and Fresenius have more ability to negotiate prices down for drugs and other needed supplies.

This has increased their profit margins and made them able to buy up even more mom-and-pop clinics. Today, the two companies own some 70 percent of U.

The dramatic drop in competition, research suggests, was amplified by declines in quality of care. That analysis, published in November in The Quarterly Journal of Economics , showed that the number of patients treated at each dialysis station also rose by 4. As a result, patient care quality dropped.

They found fewer kidney transplants, higher rates of hospitalization, and lower rates of overall survival among dialysis patients at for-profit clinics. Like all drugs, these injectables can have side effects, including increased risk of heart attack and death, especially when patients receive too high of a dose. But in , when Medicare implemented a system that lumped payment for dialysis in with the drugs used during treatment thus removing the financial incentive to over-prescribe , dosing of epoetin alfa plummeted.

The need for and use of expensive prescription medication is just one reason that treating end-stage renal disease is so costly. The high medical costs of people with kidney failure is one of the reasons that Burton suspects the insurance industry supported AB , since it would mean they had to pay less to dialysis centers. And of course, offloading expensive kidney disease patients onto government insurance would increase their own profit margins.

If they can factor that into their premium and then get those people off of their insurance, their profits go up even more. But it was the use of American Kidney Fund assistance to potentially bolster the profit margins of the dialysis companies that first triggered the fight in the California legislature. As a Premium user you get access to background information and details about the release of this statistic.

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Premium statistics. Read more. In , Fresenius Medical Center North America had over thousand dialysis patients, the most of any dialysis provider in the United States. DaVita Kidney Care followed with thousand patients on dialysis. These two dialysis providers had by far the largest number of patients in the United States.

Dialysis is required when a patient has been diagnosed with kidney failure and helps by carrying out the bodily functions that kidneys would normally do. Prevalence of kidney problems Kidney disease caused over 51 thousand deaths in the U. The states with highest number of deaths were Texas, California, and Florida in descending order. The most common cause of end-stage renal disease was diabetes, accounting for around 40 percent of cases. Other common causes include high blood pressure and glomerulonephritis.

The Fresenius Group In , the Fresenius Group is a German medical technology company which employed over thousand worldwide. Medical care is the largest segment within the company by revenue , accounting for Prevalence and Incidence.

Burden of Risk Factors. Health Consequences. Quality of Care. Health System Capacity. View Prevalence and Incidence Summary. Adults, vs. CKD Among U. State and County. View Awareness Summary. Person Awareness of CKD. Adults with CKD, vs. View Burden of Risk Factors Summary. Diabetes in the General Population. Adults with a Diagnosis of Diabetes. Adults Hypertension Adjusted by Age. Adults with a Diagnosis of Hypertension.

Obesity in the General Population. Abdominal Obesity Adjusted by Age. Estimated and Projected Population in the U. Projected U. Number of kidney dialysis clinics: There are an estimated 7, clinics providing kidney dialysis services in the United States. Based on the most recent data, the underlying ESRD dialysis patient population has grown at a compound rate of 3. Two companies, Davita Partners in the U. President Trump just signed a new executive order to increase the number of organ donations and spur development of artificial kidneys, and shift services to more home care, in an effort to cut Medicare spending in this area.

Market challenges: Several factors that could dampen revenue growth for kidney dialysis clinics over the next four years include: increased access to kidney transplants by patients, new payment models that favor home dialysis over clinic-based treatment, resulting in Medicare reimbursement cuts, and possible staff shortages and unionization of clinic technicians.