I'm not sure how much is negotiated away by the insurance company, nor how much goes through to NxStage, but there is amazing money in dialysis! Due to a computer error, my insurance status changed for January--showing me as uninsured. As a result, I received the bill for the monthly treatment myself. I was astounded to see that the combined billing for the month for my treatment was about $100,000!
I have a general idea about how much the machine costs, and I could guess how much the cartridges and dialysate solution cost. The next most expensive thing on the list are the weekly EPO shots (18000 units). Based on the bill I received, it would be possible to buy a new machine every month, with supplies for the month, and still probably have 80K left over...
Why isn't every center in the world rushing to push patients into home dialysis? Very little staff overhead--I talk the a nurse once or twice a month, and see the doctor briefly once a month. The nurse does have to do some administrative overhead related to my treatment, but not that much.
What I don't understand is how I could possibly be billed for almost $100K, when I know that Medicare only pays about $3K a month. Even at 3K, the machine is fully paid in less than a year, ongoing support and maintenance along with supplies are bound to be substantially less than the Medicare payment, so there is extra benefit to having a patient on NxStage once the cost of the machine is amortized.
How could my provider possibly justify the bill I received?