Kidney Dialysis Centers NAICS 621492

Jul 9, 2025 - One Big Beautiful Bill Includes Significant Medicaid Cuts

• President Trump has signed into law the $3.4 trillion One Big Beautiful Bill that is estimated by Healio to include $930 billion in Medicaid cuts over 10 years. Kidney dialysis centers earn the majority of their revenue through reimbursements from Medicare and Medicaid. Nearly 12 million more people may be uninsured by 2034, with many losing coverage because of the Medicaid provisions in the bill, according to a US Congressional Budget Office analysis. For the first time in the Medicaid program’s nearly 60-year history, certain able-bodied adults aged 19 years to 64 years will be required to work, participate in job training, volunteer, or enroll in school at least 80 hours a month to maintain their Medicaid benefits. This will also be required for parents of children aged 14 years and older.
• Kidneys from living donors are allowing many people with advanced kidney disease to receive transplants before their kidneys deteriorate so much that they need dialysis, according to researchers at the Mayo Clinic. Demand for dialysis may decrease if more transplants are performed earlier. Patients typically become candidates for a kidney transplant when their kidney function drops below 20%. Dialysis usually starts when function reaches around 10%. If you start thinking about transplantation at this time, it is often too late, and you will be on dialysis awhile, according to Mayo Clinic, transplant surgeon Dr. Mikel Prieto. "So that's the sweet spot: transplant between 20% and 10% of kidney function. That's what we call preemptive transplantation," Dr. Prieto says. "That's what we try to do here at Mayo. If we time things right, we can do the transplant and avoid dialysis altogether."

• 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).”
• Kidney dialysis center industry employment decreased slightly and average wages for nonsupervisory employees increased slightly during the first five months of 2025, according to the US Bureau of Labor Statistics. Kidney dialysis industry sales are forecast to increase at a 5.75% compounded annual rate from 2025 to 2029, faster than the growth of the overall economy, according to Inforum and the Interindustry Economic Research Fund, Inc.