Medicare cuts threaten rural dialysis centers

Willa Harris suffers from kidney failure. Most of her life depends on regular treatments at Wake Nephrology’s dialysis center in Raleigh.

“I've been coming to dialysis for 8 years presently. I'm on the transplant list,” said Harris.

Dr. Michael Casey works with Wake Nephrology which operates 16 dialysis clinics in Wake, Harnett and Johnson counties – serving about 800 patients.

Casey said about 85 percent of the patients of his clinics are on Medicare. That limits the profit providers can make from dialysis. Casey says Wake Nephrology gets about a 3 to 4 percent profit margin from Medicare patients.

That forces a hard decision on providers, one that Casey said most patients are not aware of.

”A lot of our clinics are just barely breaking even,” he said. If they were to start losing money, they may be forced to close. Casey says the rural clinics with a lower patient population could be the first to go. Facilities may also have to cut back on staff positions and certain service, like overnight dialysis.

“It's just a very difficult thing because these are the sickest of the sick and they require a lot of resources and services,” said Casey.

Harris believes she'll always be able to get her services at the north Raleigh clinic, but she is concerned for others who might have to travel further for treatments.