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Medicare's ESRD Program, Part 1: Dialysis.

H W Long

    Physician Executive
    |February 8, 1989
    PubMed
    Summary
    This summary is machine-generated.

    The End Stage Renal Disease (ESRD) program provides Medicare benefits for dialysis and transplants. However, specific Social Security criteria exclude about 7% of eligible ESRD patients from this entitlement.

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    Area of Science:

    • Nephrology
    • Public Health Policy
    • Medicare Administration

    Background:

    • The End Stage Renal Disease (ESRD) program, established in 1972, is a Medicare entitlement.
    • It covers renal dialysis and kidney transplantation for eligible patients.
    • Program eligibility is tied to specific Social Security insurance criteria.

    Purpose of the Study:

    • To detail the structure and scope of the federal End Stage Renal Disease (ESRD) program.
    • To identify patient populations covered and excluded by ESRD entitlement criteria.
    • To introduce the focus on renal dialysis as a primary ESRD therapy.

    Main Methods:

    • Review of federal statutes and Medicare administration guidelines for the ESRD program.
    • Analysis of eligibility criteria based on Social Security insurance requirements.

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  • Descriptive overview of renal dialysis as a core component of the ESRD program.

    • Main Results:

    • The ESRD program provides comprehensive Medicare benefits to patients diagnosed with ESRD.
    • Eligibility is contingent upon meeting specific Social Security insurance and benefit criteria.
    • Approximately 7% of all ESRD patients do not qualify for entitlement due to these criteria.

    Conclusions:

    • The ESRD program ensures access to vital treatments like dialysis for most patients.
    • A small but significant percentage of ESRD patients are excluded based on non-medical insurance criteria.
    • This article focuses on dialysis, with kidney transplantation to be discussed subsequently.