Dialysis costs revealed

By Michael Fraase

Saturday, 01 March 2008 07:27PM CST

Section: ESRD

Medical moneyBack in January, I wrote about a lawsuit in Georgia brought by National Renal Alliance against Blue Cross Blue Shield of Georgia. Blue Cross cut its “out-of-network” reimbursement rate by 88%—from US$2,900 to US$350 per treatment.

The Medicare reimbursement rate is US$200-US$250 per treatment based mostly on geographic location. Medicare covers the vast majority of end-stage renal disease patients, regardless of age. I’m a dialysis patient with private insurance.

Dialysis providers in Kentucky and Indiana are lobbying for legislation that would keep insurance payments from “falling dramatically” according to Patrick Howington’s report in the Louisville Courier-Journal. Last year, Kentucky’s largest health insurance company, Anthem, cut its “out-of-network” reimbursement rate. Some patients were forced to drive 65 miles or more to an in-network dialysis center. One patient is facing a 460 mile round-trip for in-network dialysis treatment.

What’s most interesting about this particular case is that DaVita—one of the country’s largest providers of dialysis services, and the provider of my dialysis services—has disclosed it’s cost per treatment:

“DaVita says the company’s cost per treatment averages $266, and a dialysis patient gets 156 treatments a year.

“But 87 percent of dialysis patients use Medicare, which pays only about $240 per treatment. To make up the difference, the providers charge insurance companies for the other 13 percent of patients much higher rates.

Clearly the U.S. healthcare system is broken. The most reasonable fix is a single-payer, universal coverage system: Medicare for all.

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