Fewer people with end-stage kidney disease enrolled in Medicare, study finds

The proportion of people with end-stage kidney disease enrolled in Medicare dropped from 2006 to 2016 due to policy change that made it easier for this population to access private insurance, a new study found. 

The study, published Sept. 20 in JAMA Network Open, examined public data on types of insurance coverage among adults ages 18-64 receiving dialysis for end-stage kidney disease. 

From 2006 to 2016, the proportion of dialysis patients who enrolled in Medicare during their first year of treatment fell from 73.1 percent to 58.5 percent. These decreases are connected to two policy changes, the study's authors, researchers from Durham, N.C.-based Duke University, said. 

In 2011, a new prospective payment system meant Medicare reimbursements for dialysis treatments decreased. The introduction of provisions of the Affordable Care Act in 2014 created more private insurance options for patients with end-stage kidney disease. 

"In combination, these policies and programs have raised concerns about alleged efforts by dialysis facilities to optimize revenues by increasing their proportion of privately insured patients and decreasing their reliance on Medicare," the study's authors wrote. 

The authors said, to date, there is no evidence that increasing rates of private coverage is associated with patient harm. 

"Policymakers and researchers should monitor these trends and their implications on health system and patient outcomes," the authors wrote. 


Read the full study here.

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