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News
Community-based vascular access centers are closing at an alarming rate, leaving dialysis patients — among America's most vulnerable — without timely, quality care. A ~40% Medicare reimbursement cut in 2017 triggered the closure of over 20% of these centers, pushing more patients toward infection-prone catheters. Experts are calling on Congress to fix the payment gap before more lives are put at risk.
For patients with end-stage kidney disease (ESKD), dialysis isn't optional — it's three-times-a-week survival. And the quality of their vascular access — fistulas vs. catheters — can mean the difference between life and death. Yet community-based vascular access centers, which specialize in creating and maintaining fistulas, are disappearing fast, largely due to inadequate Medicare reimbursement.
Interventional nephrologist Dr. Omar Davis paints a stark picture: a patient who went three weeks without dialysis after being bumped from a hospital procedure with no follow-up. It's a systemic failure playing out across the country, disproportionately affecting racial and ethnic minority communities who develop kidney failure at higher rates.
By the Numbers:
Why it matters: When community vascular access centers close, patients default to hospital settings where they compete with trauma cases — and often end up with catheters instead of fistulas. Fairer Medicare payment alignment across care settings could keep these centers open, reduce infections, cut costs, and save lives.
