DPC has submitted its comments responding to this year’s Medicare ESRD Payment Rule. The Medicare agency is proposing a payment update of only 1.9%, which doesn’t keep pace with increasing costs. According to the Bureau of Labor Statistics, compensation costs for civilian workers increased 3.6 percent for the 12-month period ending in June, while inflation was 2.7%. The Medicare Payment Advisory Commission recently reported that dialysis clinics’ Medicare margin was –1.1 percent in 2022 and –0.2 percent in 2023. They project a 2025 FFS Medicare margin of 0 percent.
The comment letter brought officials’ attention to the story of a dialysis program in southern Kansas that closed effective August 1st, just one year after it opened.
The clinic was established at Patterson Health Center in Anthony, KS after a community fundraising effort spearheaded by Harper County Health Foundation. Over $200,000 was raised from private donations, which was then matched by a grant from the Foundation.
The impetus for the clinic was kidney patients and their families in this remote rural area. Funds were raised from such sources as a Dollars and Dimes for Dialysis booth at the County Fair and the Chaparral High School Class of 1973 reunion. These donations supported the purchase of three Tablo dialysis machines.
Sarah Teaff, the hospital’s director, explained the economics of trying to run a small dialysis facility on Medicare reimbursements:
Our outpatient dialysis program faced a significant financial shortfall that made continued operation unsustainable. In 2024, even with generous foundation support covering start-up costs, we still operated at a loss of approximately $161,000 in a partial year.
For 2025, projections showed annual losses between $408,000 and $544,000, depending on patient volume. Reimbursement returned only about $0.42 on the dollar, creating a shortfall of nearly 60%.
Clinic leadership hoped that commercial reimbursements would make up the difference. A single patient had private insurance, but the insurer has refused to pay.
