Erickson KF, Eck C. Considering the Effects of a Recent US Supreme Court's Ruling on Dialysis Care Costs.
Clin Ther 2023;
45:272-276. [PMID:
36842865 PMCID:
PMC10133009 DOI:
10.1016/j.clinthera.2023.01.015]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/25/2023] [Accepted: 01/27/2023] [Indexed: 02/27/2023]
Abstract
Dialysis care in the United States is expensive and is mostly paid for by Medicare. To reduce the cost of providing dialysis services, the federal government has relied on a law that designates Medicare as a secondary payer in the first 30 months of dialysis. During this period, private health insurers are the primary payer and pay for the majority of dialysis-related costs. Private health insurers often pay substantially higher prices for dialysis care than does Medicare, possibly due to highly concentrated dialysis-provider markets. A perspective by Boumil and Curfmin in this journal discusses how a recent ruling by the US Supreme Court may limit Medicare's role as a secondary payer, potentially altering the economic relationship between dialysis providers and private insurers. Boumil and Curfmin discuss how these changes may ultimately promote competition in dialysis-provider markets and lower dialysis-related costs paid by private health insurers. We compare this viewpoint to responses and concerns voiced by other stakeholders in the kidney-care community and outline additional ways in which the Supreme Court's ruling may affect competition in dialysis markets and prices paid for dialysis by private insurers.
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