In 2012, about 370,000 ESRD patients in the Medicare program received dialysis treatment in 5,800 facilities, according to a March report to Congress by the Medicare Payment Advisory Commission. Medicare spent a total of $10.7 billion for dialysis in 2012, a 6% increase from 2011. That spending covered the dialysis procedures, medications and ESRD-related lab tests.
The majority of centers are freestanding clinics, which make up 92% of all dialysis facilities in the U.S. and accounted for 93% of Medicare dialysis spending in 2012. While the number of hospital-based and not-for-profit facilities has decreased in recent years, the share of for-profit centers has increased, from 82% in 2008 to 86% by 2013, according to MedPAC.
The growth in dialysis facilities, which has increased by 6% annually over the past five years, has been accompanied by an increase in the population of Americans diagnosed with ESRD. That total rose from 411,000 in 2001 to more than 615,000 by 2011 as more Americans developed chronic conditions such as diabetes and hypertension. While the share of Americans receiving dialysis dropped by 2 percentage points during that period, the overall number of patients receiving dialysis increased from 296,000 in 2001 to more the 430,000 by 2011, according to government figures. The incidence rate for ESRD in the U.S. was 425 per million people in 2010, second only to Mexico.
One reason the system's problems have evolved out of the health care spotlight is that kidney failure disproportionately afflicts minorities and the dispossessed. But given a patient pool growing by 3 percent a year and the outsize 6 percent bite that the kidney program takes from the Medicare budget, we ignore dialysis at our own risk. "We're offering our patients a therapy we wouldn't accept for ourselves," said Dr. Tom F. Parker III, a Dallas nephrologist and national advocate for better care. More and more leaders in the field, he said, "are starting to say this isn't sufficient."
Currently, more than 20 million Americans have some level of chronic kidney disease. That's related to an increase in diabetes, the most common cause of renal failure. Experts predict that as the prevalence of diabetes increases, so will the demand for dialysis.
kidneyhospitalabroad@hotmail.com
The majority of centers are freestanding clinics, which make up 92% of all dialysis facilities in the U.S. and accounted for 93% of Medicare dialysis spending in 2012. While the number of hospital-based and not-for-profit facilities has decreased in recent years, the share of for-profit centers has increased, from 82% in 2008 to 86% by 2013, according to MedPAC.
The growth in dialysis facilities, which has increased by 6% annually over the past five years, has been accompanied by an increase in the population of Americans diagnosed with ESRD. That total rose from 411,000 in 2001 to more than 615,000 by 2011 as more Americans developed chronic conditions such as diabetes and hypertension. While the share of Americans receiving dialysis dropped by 2 percentage points during that period, the overall number of patients receiving dialysis increased from 296,000 in 2001 to more the 430,000 by 2011, according to government figures. The incidence rate for ESRD in the U.S. was 425 per million people in 2010, second only to Mexico.
One reason the system's problems have evolved out of the health care spotlight is that kidney failure disproportionately afflicts minorities and the dispossessed. But given a patient pool growing by 3 percent a year and the outsize 6 percent bite that the kidney program takes from the Medicare budget, we ignore dialysis at our own risk. "We're offering our patients a therapy we wouldn't accept for ourselves," said Dr. Tom F. Parker III, a Dallas nephrologist and national advocate for better care. More and more leaders in the field, he said, "are starting to say this isn't sufficient."
Currently, more than 20 million Americans have some level of chronic kidney disease. That's related to an increase in diabetes, the most common cause of renal failure. Experts predict that as the prevalence of diabetes increases, so will the demand for dialysis.
kidneyhospitalabroad@hotmail.com
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