Kidney Dialysis Centers
Industry Profile Report
Dive Deep into the industry with a 25+ page industry report (pdf format) including the following chapters
Industry Overview Current Conditions, Industry Structure, How Firms Operate, Industry Trends, Credit Underwriting & Risks, and Industry Forecast.
Call Preparation Call Prep Questions, Industry Terms, and Weblinks.
Financial Insights Working Capital, Capital Financing, Business Valuation, and Financial Benchmarks.
Industry Profile Excerpts
Industry Overview
The 8,400 kidney dialysis centers in the US provide dialysis treatment for patients with end stage renal disease (ESRD), also known as chronic kidney failure. Patients with ESRD require dialysis treatments or a kidney transplant to sustain life. Dialysis is the removal of toxins, fluids, and salt from the blood of patients by artificial means.
Competing with Large Companies
The US kidney dialysis center industry is dominated by two large players – Fresenius Medical and DaVita – which together have 72% of the market.
Dependence on Government Reimbursements
Kidney dialysis centers earn the majority of their revenue through reimbursements from Medicare and Medicaid, since all ESRD patients are covered by Medicare, regardless of their age or financial circumstances.
Industry size & Structure
A typical kidney dialysis center has 15 employees and generates about $3-4 million in revenue.
- The kidney dialysis center industry in the US consists of 500 firms operating about 8,400 centers, employing 130,000 workers, and generating $28 billion in annual revenue.
- The industry is highly concentrated, as the two largest firms – Fresenius Medical and DaVita – treat about 80% of kidney dialysis patients in the US and account for 72% of outpatient dialysis centers.
- Other large kidney dialysis firms include US Renal Care, Dialysis Clinic, Inc., American Renal Associates, and Satellite Healthcare.
- There are about 558,000 patients receiving dialysis treatment in the US.
- 86% of US dialysis patients receive hemodialysis treatment, usually at a kidney dialysis center. About 2% receive hemodialysis at home. About 14% of dialysis patients receive peritoneal dialysis, usually at home.
Industry Forecast
Kidney Dialysis Centers Industry Growth
Recent Developments
Nov 14, 2024 - ESRD Prospective Payment Base Rate Increase Finalized
- The Centers for Medicare and Medicaid Services finalized the end stage renal disease prospective payment system base rate at $271.02 for 2025. The final base rate is an increase of 2.1% over the 2024 base rate of $271.02. The rule includes new requirements, effective January 1, 2025, for reporting on ESRD PPS claims, of “time on machine” data (that is, the amount of time that a beneficiary spends receiving in-center hemodialysis treatment) and reporting of discarded amounts of certain renal dialysis drugs and biological products from single-dose containers and single-use packages. It also finalizes a new transitional add-on pediatric ESRD dialysis payment adjustment for CYs 2024, 2025, and 2026, which is expected to promote equitable and accurate payments, since treatment for the pediatric ESRD population tends to be especially complex and costly.
- Older patients with kidney failure who started dialysis right away lived for an average of 770 days — just 77 days longer than those who never started it, according to a study published in the journal Annals of Internal Medicine. The patients also spent an average of two more weeks in hospitals or care facilities in addition to the time spent undergoing dialysis. “For all patients, but particularly for older adults, understanding the trade-offs is really essential,” said Manjula Tamura, MD, a professor of nephrology and the senior author of the study. “They and their physicians should carefully consider whether and when to proceed with dialysis.”
- Administrators of independent dialysis clinics said in a letter to Congressional leaders that intervention is needed to avoid staffing cuts because of inadequate Medicare payments. The letter cites a recent study by Prima Health Analytics which found that dialysis facilities have accumulated $1.7 billion in losses over the last 3 years. On average, facilities lost 42% of operating expenses in excess of revenues, totaling $320,000 per facility per year. “A mere 3% increase to the base rate for [calendar year] 2023 is woefully inadequate in this time of economic and staffing instability. With absent action from Congress, access to care and the quality of care for individuals relying on Medicare for their dialysis services will be jeopardized,” the letter said.
- Kidney dialysis center industry employment was unchanged while average wages for nonsupervisory employees increased slightly during the first nne months of 2024, according to the US Bureau of Labor Statistics. Kidney dialysis industry sales are forecast to increase at a 5.1% compounded annual rate from 2024 to 2028, faster than the growth of the overall economy, according to Inforum and the Interindustry Economic Research Fund, Inc.
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