April 2008

Background

At the time of this study, over 200,000 patients in the United States with end-stage renal disease were undergoing dialysis, mostly (2/3) at for-profit centers. Various economic pressures, such as declining inflation-adjusted Medicare payments for dialysis and loss of dialysis center revenue if dialysis patients were instead referred for transplant consideration, prompted this study to determine if quality of care was compromised in for-profit centers.