Kidney Diet Tips

CMS Dialysis Cuts: What It Means for Patients

Advocacy highlighted in yellowIf you are a patient receiving dialysis treatments, a family member or caregiver of a dialysis patient, or an active member of the kidney care community, this post has an important message and request for your help. In early July, the Centers for Medicare and Medicaid Services (CMS) proposed a nearly 10% reduction in payment for dialysis treatments. If you do not have time to read on, please take 90 seconds of your time to oppose these cuts, which, if implemented, will limit patients’ access to life-saving care because of resulting dialysis staffing reductions and center closures in some areas.

Go to to send a letter to Congress. Tell your Congress members that cutting nearly 10% from an essential program will hurt some of the most vulnerable people in the American healthcare system—those who depend on dialysis to stay alive.

So what exactly could less money from CMS mean for dialysis patients and providers?

Fewer dialysis centers for patients to choose from. Before the new cuts were proposed, Medicare already failed to cover the cost of dialysis adequately. The deep new cuts would mean that providers would likely have to close some centers—including ones that are located in urban and rural areas that need care the most.

Fewer new or upgraded centers. This is particularly concerning because the number of patients requiring dialysis increases as our population continues to age and  as rates of diabetes and hypertension increase, two of the main reasons kidneys stop working.

Fewer evening and nighttime shifts. It takes a team of doctors, nurses, administrators, patient care technicians, dietitians, social workers and more to run a dialysis center. When resources are decreased, fewer centers are able to hire and pay to staff extended clinic hours. This creates less flexibility to accommodate working patients, which could have a significant impact on patients and their families who depend on income from their jobs.

Fewer home dialysis programs. Again, the ability to maintain facility staffing levels sufficiently enough to provide a full range of services could influence decisions to open new programs for both peritoneal dialysis and home hemodialysis.

Less time at home or work. Center hour reductions and closures could mean that some patients have to travel farther to get dialysis. Rural dialysis centers with fewer patients are most likely to be impacted. Already some patients travel long distances for their treatment three times a week. Five miles versus 40 miles each way—how would that impact you?

Less innovation to improve dialysis and kidney care in the future. We look back over the past 40 years and see advances in treatment options, medications, dialysis access techniques and other best practices that have significantly improved quality of life for hundreds of thousands of dialysis patients. Without fair reimbursement for treatment—just enough to cover the bare minimum cost of delivering dialysis—further advances in kidney care are at risk because providers won’t have the same ability to invest in them. Through multiple clinical initiatives, DaVita has improved outcomes for 13 years in a row and continues to be the best or among the best in virtually every category. That has meant dramatic reductions in patient hospitalizations and mortality rates. We have such incredible momentum in clinical innovation now. The future should offer opportunities to continue to improve.

The purpose of outlining potential future scenarios is not to create fear. Rather, it is to encourage action because this is something we can actually influence. We have until the end of August to be heard. If you haven’t done so already, consider taking the following actions:

  1. Take 90 seconds to go to and send letters to your three members of Congress. A pre-written message is available, and you can add your comments to it. Act today—make sure your Congress members know that cutting nearly 10% from the dialysis program will hurt people who depend on dialysis to stay alive.
  2. Tell your coworkers, patients, physicians, family members and friends to do the same. Send them an E-Card about it at
  3. Post messages on Facebook and Twitter. Simply copy and paste these sample posts on your social sites and encourage your friends and family to do the same:
    • Facebook: Friends and family: Help protect access to dialysis. More than 80% of dialysis patients rely on Medicare for their care. Tell Congress to stop Medicare cuts before they start. We need your help:
    • Twitter: Help protect access to dialysis. Tell Congress to stop Medicare cuts before they start. We need your help:
  4. Consider a visit to your local Congressmember’s or senator’s office to voice your concerns.


I welcome your comments on this post as others who have already expressed their concerns.

Kidney diet resources from

Sara Colman, RD, CDE

Sara is a renal dietitian with over 20 years experience working with people with diabetes and kidney disease. She is co-author of the popular kidney cookbook "Cooking for David: A Culinary Dialysis Cookbook". Sara is currently the Manager of Kidney Care Nutrition for DaVita. She analyzes recipes and creates content, resources and tools for the kidney community. In her spare time Sara loves to spend time with her young grandson, including fun times together in her kitchen.