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Research Letter
Health Care Policy and Law
March 22, 2021

Payment for Dialysis Services in the Individual Market

Author Affiliations
  • 1University of Southern California Schaeffer Center for Health Policy and Economics, Los Angeles
  • 2USC-Brookings Schaeffer Initiative for Health Policy, Washington, DC
  • 3USC School of Pharmacy, Los Angeles, California
  • 4Brookings Institution, Washington, DC
  • 5USC Keck School of Medicine, Los Angeles, California
  • 6USC Price School of Public Policy, Los Angeles, California
JAMA Intern Med. 2021;181(5):698-699. doi:10.1001/jamainternmed.2020.7372

Although 80% of US patients who receive dialysis for end-stage kidney disease (ESKD) have Medicare as their primary payer, recent evidence suggests an increasing share with other coverage.1 Some policy makers allege that dialysis facilities encourage individual market enrollment by subsidizing individual market premiums through contributions to patient assistance foundations.2 This strategy could increase profits for facilities because commercial plans pay more for dialysis than Medicare,3 but could also increase individual market spending if patients receiving dialysis have above-average spending.

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