Potential Impact of ESRD Payment Reform on Rural Dialysis Patients

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.

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