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U.S. Kidney Dialysis Clinics: An Industry Analysis

  • ID: 4803801
  • Report
  • July 2019
  • Region: United States
  • 82 Pages
  • Marketdata LLC
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  • Davita Kidney Care
  • Fresenius Medical Care
  • U.S. Renal Care
  • MORE

This analysis examines the $24.7 billion kidney dialysis centers sector - a growth industry.  The kidney dialysis business is highly concentrated, with the 4 largest competitors comprising more than 85 % of the market, but substantial competition still takes place.

While there are a few large national companies, Fresenius Medical Care and DaVita Healthcare Partners, this industry is experiencing heightened M&A activity from both strategic suitors and private equity investors. The industry has come under scrutiny by the government for some of its practices and very high-profit margins, and there is a push toward cheaper home dialysis services to save Medicare dollars.

This study examines the nature of the industry, types of dialysis used, national receipts/growth from 2007 to 2023 forecast, customer demand and demographics, key industry trends, industry structure and operating ratios (national and state Census data for establishments and firms), industry regulation, top companies market share, insurance/ Medicare reimbursement trends, emerging home dialysis services, and more.

Competitor Profiles for Fresenius Medical Care, DaVita Healthcare Partners, and U.S. Renal Care.

Note: Product cover images may vary from those shown
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  • Davita Kidney Care
  • Fresenius Medical Care
  • U.S. Renal Care
  • MORE

1. Report Scope and Methodology

  • Sources and methodology used for the report, report scope.                  

2. Nature & Structure of the Industry                                                          

  • Definition and number of kidney dialysis centers in the U.S. worldwide
  • Major industry trends and issues: consolidation, push for home dialysis, Medicare and insurance reimbursement, new 2019 Trump executive order, staff shortages, fines & investigations of the leaders.
  • Main types of dialysis: hemodialysis, peritoneal dialysis, acute dialysis
  • Discussion of home dialysis options: cost savings, cycler devices
  • Industry structure: key metrics: no. of facilities, receipts, annual payroll, no. of employees, avg. receipts per facility – 2002, 2007, 2012, 2016
  • Main operating models used by kidney dialysis centers
  • Factors affecting demand for kidney dialysis (aging population, obesity, diabetes, organ transplants and donations, economy)
  • Operations: sources of revenue, typical patient volumes, revenues per patient visit, facility profit margins  
  • Competition and Consolidation: discussion of main competitors, interest by venture capital, NIH study of consolidation from 2001-2011 and its effect on patient choices
  • Reimbursement situation discussion, requirements and cuts under Medicare
  • Tables:
    • Kidney Dialysis Industry Snapshot: 2016, 2012, 2007, 2002

3. Market Size, Growth, Forecasts                                                                            

  • Estimates of industry size and growth published by other research firms (IBIS World, First Research, Anything Research, NEJM Catalyst, Marketdata)
  • Size / Annual Receipts of kidney dialysis centers industry from 2007-2016, official government Census 5-year survey data and annual County Business Patterns data
  • Estimates & forecasts of receipts for 2017-2019, 2023 F
  • Discussion & analysis of historical growth trends, during the last recession, recovery since then, current situation, rationale for forecasts
  • Discussion of major factors affecting industry growth: reimbursement, demand, aging of population, obesity, increase in lifestyle diseases, organ donations, etc.
  • Tables:
    • Size of the U.S. Kidney Dialysis Market: 2007-2016
    • Annual Growth Rate of the Kidney Dialysis Market: 2007-2016
    • Revenues of the leaders (Davita, Fresenius) for 2012-2018
    • Forecast Size of the U.S. Kidney Dialysis Market: 2017, 2018, 2019, 2023

4. Customer Demographics                                                                                    

  • Discussion and statistics related to population aging trends
  • Discussion and statistics related to obesity trends
  • Discussion and statistics related to diabetes trends
  • Discussion and statistics related to kidney failure and ESRD (end stage renal disease) trends
  • Discussion and statistics related to kidney transplants
  • Tables:
    • Prevalence of obesity in the U.S. by state and region: 2000-2017
    • Participants with diabetes, self-reported cardiovascular disease: 2007-2012
    • Hospital discharge status of first AKI hospitalization for Medicare patients aged 66+, 2013
    • Causes of death in ESRD patients, 2012-2014
    • All-cause mortality rates (per 1,000 patient years at risk) for Medicare patients aged 66+, by CKD status and year, 2001-2013

5. Industry Economic Operating Ratios

  • Summary of key industry metrics, NAICS code for the industry, what it includes
    • Industry snapshot: 2002, 2007, 2012, 2016: key ratios (payroll, no. estabs., receipts, Avg. receipts per estab.)
    • Annual % change in receipts: 2007-2016
  • Industry ratios (no. of firms, establishments, receipts, payroll as % receipts for 2012) by:
    • legal form of organization -corporations, sole proprietorships, partnerships: no. of employees).
    • Single vs. multi-unit operations, by size (statistics as above)  
    • Concentration Ratios: ratios for top 4, 8, 20, 50 largest firms  
    • Receipts size of establishments (under $10,000 to $10+ mill.)
    • Receipts size of firms (under $100,000 to $100+ mill.)
    • No. of establishments, receipts & avg. receipts per establishment, by state: 2012
    • No. of establishments, receipts & avg. receipts per establishment, by state – 2016
    • (County Business Patterns, Estimates)

6. Competitor Profiles

(description and history of company, no. of clinics operated, headquarters address, specialties, acquisitions, services, financial data when available, 2018 results, fines and actions against the company)

  • Fresenius Medical Care
  • Davita Kidney Care
  • U.S. Renal Care

7. Reference Directory               

  • List of kidney dialysis national/regional trade associations, journals, consulting firms, reports, articles, other key contacts – address & phones, description of activities.
Note: Product cover images may vary from those shown
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  • Davita Kidney Care
  • Fresenius Medical Care
  • U.S. Renal Care
Note: Product cover images may vary from those shown
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