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
Mar 10, 2025 - Kidney Disease On Track To Become World’s Fifth Leading Cause Of Death
- Chronic Kidney Disease is on trend to become the fifth leading cause of death worldwide by 2050, according to the Medical Advisory Council of the Global Patient Alliance for Kidney Health. The disease has been trending upwards as a cause of death for years, moving up from ninth in 2019 and 18th in 1990. The absence of symptoms until the disease is well advanced can mean that kidney disease is often not diagnosed until it’s too late to avoid kidney failure. Up to 90% of kidney function can be lost without symptoms, meaning diagnosis is often too late.
- Fewer patients starting dialysis are enrolling in Medicare since the introduction of the Affordable Care Act (ACA) in 2014 and are instead opting for private insurance, according to a study published in in JAMA Health Forum. The ACA expanded access to private insurance by preventing plans from denying coverage because of preexisting conditions, promoting state insurance exchanges, and relaxing special enrollment periods. “Dialysis expenditures for privately insurance patients were at least twice as high as patients with Medicaid who enrolled in Medicare after dialysis initiation and several times higher for patients with Medicaid who did not enroll in Medicare,” the investigators note. “This may lead to unnecessarily high overall societal costs and inequitable access to care for some patients, which ultimately affects payers, patients, and overall consumers (ie, overall consumer health care insurance premiums are not limited to patients with ESKD).”
- 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.
- 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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