The cost of emergency dialysis is estimated to be 8-times that of in-center dialysis. A new study reveals that a transitional dialysis program piloted in Travis County (Austin, TX) resulted in a significant decrease in emergency department visits and hospital admissions for emergency dialysis by providing a pathway for outpatient dialysis in uninsured patients.
The findings were presented at ASN Kidney Week 2025, held November 5–9.
Central Health, an organization that provides health and wellness services for uninsured patients in Travis County, piloted the transitional dialysis program in November 2022. The goal was to provide in-center/outpatient dialysis for Travis County residents who lacked insurance coverage.
When investigators reviewed data from November 2022 to December 2024 on the 101 patients who enrolled in the program, they observed that there was a significant decline in the number of days patients utilized emergency dialysis in the hospital prior to finding an outpatient facility. Additionally, within one year of starting dialysis, most patients were able to obtain permanent dialysis access with either an arteriovenous fistula or a peritoneal dialysis catheter.
Once accepted into the program, Central Health provided an insurance plan to cover outpatient dialysis and transplantation. To date, 18 patients have been listed for kidney transplantation, and two have received living donor transplants.
The program has successfully facilitated dialysis access placement and transplant evaluation. Since Texas has no safety-net plan for patients who do not qualify for Medicare or Medicaid, the program has the potential to provide a cost-effective solution and decrease in utilization of health care resources for those without medical coverage who develop kidney failure. It can be a model for other states and cities that also lack safety net plans."
Michelle Lubetzky, MD, corresponding author, The University of Texas, Austin
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