DialysisPPO, located in suburban Philadelphia, Pennsylvania, was founded in 2006 to help group health plans and their partners manage the exceptionally high cost of chronic, long-term dialysis cases for the treatment of End-Stage Renal Disease ("ESRD").
The reimbursement environment for renal dialysis services is unlike any other in U.S. healthcare for two reasons. Firstly, ESRD is the only Medical diagnosis that entitles a patient to Medicare — regardless of their age. Secondly, over the course of the past decade, consolidation amongst dialysis providers has resulted in two large organizations treating approximately 75% of all U.S. dialysis patients. The confluence has created a cost environment that is exceptionally challenging for group health plans. It is not unusual for monthly charges to exceed $125,000.
Our patented program enables group health plans to capitalize on the unique Medicare reimbursement aspects of this costly disease. Plans do not need to wait 33 months for Medicare to become the primary payer to begin saving – our program can be implemented immediately for most clients. Our program yields average client savings of approximately $100,000 per dialysis case per month.