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About Kidney Disease
and Dialysis
According to the Centers for Disease Control, over 35 million Americans are living with chronic kidney disease. That's more than 1 in 7 American adults.
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As many as 90% of those with chronic kidney disease don't know they have it.
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If chronic kidney disease isn't treated, the kidneys fail and a patient develops end-stage renal disease. A transplant or dialysis is necessary to survive. Without treatment, a patient can die within weeks. Over 800,000 Americans are currently living with end-stage renal disease. Even with treatment, the five-year survival rate for patients with end-stage renal disease is 25-35%.
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In 2020, the most recent year for which data is available, over 130,000 Americans started treatment for end-stage renal disease. In 2022, there were nearly 89,000 Americans waiting for a kidney transplant; only 25,000 transplants were performed.
Dialysis
Dialysis is a life-sustaining procedure necessary for patients in kidney failure to survive. The procedure involves pumping a patient's blood through an external filter - a process that typically takes 3-5 hours, three times per week.
In 1972, Congress passed an amendment to the Social Security Act providing that kidney failure would qualify as a disability and thus entitle the patient to Medicare coverage of dialysis or a kidney transplant after a three-month waiting period. If an individual is covered by an employer-sponsored health plan at the time of diagnosis, the employer-sponsored plan is the primary payor for treatment for three months, after which time Medicare becomes the primary payor.
Medicare Coverage
Policy Issue
The commercial dialysis market in the U.S. is controlled by just two companies: Fresenius, which treats 38% of patients, and DaVita, which treats 36% of patients. Together, these two companies form what we call Big Dialysis.
Big Dialysis is currently asking Congress to rewrite over 40 years of established policy and change the Medicare Secondary Payer Act ("MSPA"). Changing the MSPA will give them more market control and force employers and employees to pay more for dialysis, all while saying that such profit-seeking changes will protect patients.