Potential Impact of ESRD Payment Reform on Rural Dialysis Patients

Research center:
Project funded:
September 2015
Project completed:
November 2017

With the projected reduction in payments to rural providers by 2018, it is anticipated that rural facilities may be at risk for closure, particularly those with low profit margins or patient volumes. This study will estimate the potential implications of rural dialysis facility loss for rural patients. Specifically, we will identify low-volume dialysis facilities in rural areas, profile the patients they serve, and estimate the additional travel burden that these patients would experience if facilities close. Data on ESRD utilization, by patients and facilities, will be drawn from the 2014 U.S. Renal Data System, linked with the CMS public use Facility Level Impact File, the CMS Dialysis Facility Compare Data, and the CMS Costs Reports. County-level community characteristics will be drawn from the Area Resource File.


  • ESRD Facility Characteristics by Rurality and Risk of Closure
    Rural and Minority Health Research Center
    Date: 11/2017
    This study's purpose was to profile rural end stage renal disease (ESRD) facilities, focusing on those at greatest risk for closure. We examined the characteristics of these facilities, the quality of care provided, and the distance patients in rural areas would have to travel if the facilities closed.