DaVita Strikes Again

[thegrammalady]

apparently DaVita is going to stop accepting some private  insurances. Anyone have more information?

[Bill Peckham]

This usually happens when an insurer refuses to pay the full charges. DaVita can't let insurers dictate prices so they will draw a hard line unless an insurer has enough of their beneficiaries dialyzing to have the leverage to demand concessions.


What did you hear? I'd guess it is a small insurer, with few patients, getting exorbitant per treatment charges in an area with little or no competition.

[thegrammalady]

Bill, Denver has plenty of competition.

[Bill Peckham]

Interesting - is this connected to the lawsuit in Denver against DaVita?

[thegrammalady]

I have no idea. All I know is the staff at my center was told that they might get some of these full pay patients and they could have whatever time they wanted and the Medicare patients would just have to take whatever was left. ARA is opening a new center and I hope to be moved in the next two weeks.

[Simon Dog]

This usually happens when an insurer refuses to pay the full charges. DaVita can't let insurers dictate prices so they will draw a hard line unless an insurer has enough of their beneficiaries dialyzing to have the leverage to demand concessions.


What did you hear? I'd guess it is a small insurer, with few patients, getting exorbitant per treatment charges in an area with little or no competition.

The "full charges" are off-scale, and insurance companies generally pay some sort of negotiated rate.   I know my FMC clinic charges over $3K (list) for a single HD treatment; collected $445 from my private insurer and would accept about $245 if I were on medicare.  I recently had an out of town treatment at DaVita and they took my insurance.

My doc (medical director of a Fresenius clinic) told me a patient of his was recently traveling and that a Fresenius clinic refused him because his insurance paid too little ... so the Fresenius staff found a DaVita clinic that would treat him.