The Success of Medicare's End-Stage Renal-Disease Program

Abstract

The 92d Congress extended Medicare benefits to patients with end-stage renal disease (ESRD), sparing patients the financial burden of treating this catastrophic illness. The costs of the ESRD program have been contained better than those of health care generally; payment was originally limited by a screen of $138 per dialysis but could be higher if higher cost was documented. About 48 per cent of patients receive dialysis in units outside hospitals. The majority of these units are operated for profit, in which physicians share. The payment to these facilities has remained constant while payment to the nonprofit hospitals' units has increased markedly.