I’m are for get more from the gove’t when possible. How can we find out what bottom line is for centers? I’m not saying there should not make $ but should they not be treated like other life saving groups. Can you think what if for profit hospitals close on weekends or were only open 12 hrs a day.
I don’t mean to make excuses for dialysis clinics and definitely believe that some charge way too much. Medicare does limit the reimbursement for Medicare patients to an allowed rate (called the composite rate) for dialysis and to an allowed rate for drugs. And providers that accept Medicare assignment of benefits must accept 100% of Medicare’s allowable as payment in full. Dialysis providers can only bill patients with Medicare Part B the annual deductible and coinsurance (20%) and if the employer group plan pays more than the Medicare allowable, the clinic has to accept that amount and can’t bill the patient any more.
Like other businesses, a dialysis clinic can charge a commercial insurance or a patient who doesn’t have Medicare what market will bear. If there is a contract between the insurance company and the dialysis clinic, the insurance company will reduce payment to the clinic to that contracted amount. This is basically the same way it works for hospitals and doctors.
I encourage patients to sign up for Medicare Part A and Part B to limit their liability to hospitals and dialysis clinics to 100% of Medicare’s allowable. In dialysis, this means that clinics must write off any amount that they charge that is over 100% of Medicare’s allowable.
I don’t know what the profit margin is for any dialysis clinics. You can find the financial reports for dialysis providers on sites like http://finance.yahoo.com/. I believe you have to know the company’s symbol or you can type in the name into the symbol lookup. If you’re looking at dialysis corporations’ financial statements remember that some do more than run dialysis clinics. Some are vertically integrated. They make and sell machines and supplies, operate labs, pharmacies, vascular access services, etc.
As far as I know, there is no special treatment (or lower allowable charge) for life saving groups. There is special treatment for entities that have applied for an received IRS designation as a nonprofit organization. Some dialysis providers are nonprofit, but most are for profit entities. I don’t know that much about tax status but as I understand it, even nonprofits can make money, but they have to put the money into operations or reserves (rainy day funds).