By Bill Peckham
RenalWeb links to a story out of Atalanta about the imminent closing of Grady Memorial Hospital, Grady says it will pay to fly dialysis patients to their home country. It's an amazing story of an urban dialysis unit that is closing its doors in the face of mounting losses. As part of the process of closing the unit Grady is going to pay to relocate some 60 of its uninsured patients. If the effected patients choose to not relocate Grady has said it will pay a private dialysis provider to dialyze the patient.
No entity can sustain losses year after year. Grady is struggling "with an expected $35 million operating deficit this year". Something has to give but the reported costs deserve some scrutiny:
Grady officials said they plan to close the outpatient dialysis unit because the clinic is old, uses outdated equipment and has lost between $2 million and $4 million a year in recent years.
The problem is that about 60 of the clinic’s 90 patients are undocumented immigrants who cannot collect government aid such as Medicaid. That makes it difficult to transfer them to a private provider.
Virtually none of these 60 patients has insurance or government assistance.
$33,000 to $66,000 in losses per year, per patient?
That cost can't be just the dialysis or the costs associated with running the clinic, it must represent the total MEDICAL cost of each patient - doctor and hospital visits too.
The problem isn't the unit - old equipment can be replaced - it's Grady's payer mix. A nonprofit dialysis provider could survive in Atlanta but they would need a representative patient population. It would be difficult for any nonprofit to survive if their only patients were those that for-profit dialysis providers refuse to treat. Grady can no longer sustain the cost of cherry picking.
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