Loading
A data-driven snapshot of the US dialysis facility market from CMS Dialysis Facility Compare data: chain concentration, state-level capacity and quality, home therapy access, and facility growth since the 1970s.
Dialysis in the US is one of the most consolidated outpatient sectors in healthcare. Two national chains own a majority of certified facilities.
7,490 CMS-certified facilities, 90.1% chain-owned. 6,706 facilities operate as for-profit (89.5%), 784 as non-profit (10.5%).
| Chain / Ownership | Centers | Stations | Center share | Avg star rating | Avg SIR | Avg catheter use % | Avg HD adequacy % |
|---|---|---|---|---|---|---|---|
| DaVita | 2799 | 48930 | 37.4% | 3.0 | 0.3 | 17.0 | 71.5 |
| Fresenius Medical Care | 2701 | 51077 | 36.1% | 2.9 | 0.3 | 18.8 | 98.1 |
| Independent | 742 | 10091 | 9.9% | 2.3 | 0.6 | 26.5 | 87.8 |
| US Renal Care, Inc. | 453 | 8007 | 6.0% | 3.1 | 0.3 | 17.7 | 96.7 |
| Dialysis Clinic, Inc. | 243 | 4551 | 3.2% | 2.7 | 0.3 | 19.4 | 95.6 |
| American Renal Associates | 218 | 4170 | 2.9% | 3.0 | 0.4 | 17.9 | 97.3 |
| Other | 95 | 1355 | 1.3% | 2.1 | 0.5 | 25.1 | 86.7 |
| Kaiser Permanente | 22 | 97 | 0.3% | 3.8 | 0.8 | 19.0 | 98.0 |
| State Owned | 19 | 400 | 0.3% | 2.1 | 0.6 | 31.6 | 97.4 |
| Wake Forest University | 19 | 549 | 0.3% | 2.7 | 1.1 | 23.7 | 98.1 |
| Northwest Kidney Centers | 19 | 378 | 0.3% | 3.3 | 0.9 | 13.0 | 97.8 |
| Centers for Dialysis Care | 18 | 389 | 0.2% | 1.6 | 0.8 | 24.1 | 94.2 |
| Atlantis Healthcare Group | 17 | 502 | 0.2% | 1.2 | 0.3 | 40.1 | 99.0 |
| Greenfield Health Systems | 15 | 321 | 0.2% | 2.2 | 0.6 | 25.7 | 96.4 |
| Sanford Health | 13 | 131 | 0.2% | 3.6 | 1.6 | 13.7 | 98.7 |
| Atlantic Dialysis Management Services | 13 | 350 | 0.2% | 3.2 | 0.1 | 17.6 | 91.2 |
| Mayo Clinic Dialysis | 12 | 204 | 0.2% | 2.4 | 0.9 | 37.1 | 98.7 |
| Puget Sound Kidney Centers | 11 | 197 | 0.1% | 3.1 | 1.3 | 20.0 | 97.8 |
| Diversified Specialty Institutes (DSI) | 8 | 147 | 0.1% | 2.6 | 0.4 | 20.1 | 96.4 |
| Central Florida Kidney Centers | 7 | 145 | 0.1% | 1.4 | 0.5 | 24.4 | 97.0 |
| Intermountain Healthcare | 7 | 95 | 0.1% | 3.5 | 1.4 | 14.0 | 96.2 |
| Satellite Healthcare | 6 | 102 | 0.1% | 3.0 | 0.4 | 22.2 | 93.0 |
| Independent Dialysis Foundation (IDF) | 6 | 124 | 0.1% | 2.5 | 0.4 | 25.5 | 96.7 |
| Gundersen Lutheran | 5 | 84 | 0.1% | 3.3 | 1.5 | 23.5 | 97.5 |
| Satellite Dialysis | 4 | 71 | 0.1% | 1.3 | 0.3 | 23.3 | 95.0 |
| North Central Pennsylvania Dialysis Clinics | 4 | 55 | 0.1% | 2.3 | 2.8 | 25.3 | 97.3 |
| Scott & White Memorial Hospital | 4 | 116 | 0.1% | 2.0 | 0.6 | 22.5 | 95.8 |
| Innovative Dialysis Systems | 3 | 31 | 0.0% | 4.0 | 0.2 | 15.5 | 99.0 |
| Veterans Administration | 3 | 30 | 0.0% | — | — | — | — |
| UPMC Health System | 2 | 24 | 0.0% | — | — | — | — |
| Dallas County Hospital District | 1 | 5 | 0.0% | — | — | — | — |
| Memorial Hermann Healthcare System | 1 | 7 | 0.0% | — | — | — | — |
Quality columns computed only where data is available; ratings suppress small or new facilities ("Not Available" excluded). Averages shown for chains with ≥20 facilities.
Capacity is unevenly distributed. The table below ranks states by facility count with aggregate quality indicators.
| State | Centers | Stations | Chain-owned % | Avg star rating | Avg catheter use % | Avg HD adequacy % |
|---|---|---|---|---|---|---|
| TX | 745 | 14248 | 95% | 2.9 | 16.1 | 96.1 |
| CA | 734 | 15400 | 88% | 3.3 | 17.9 | 95.1 |
| FL | 533 | 9028 | 85% | 2.3 | 21.9 | 94.3 |
| GA | 355 | 5956 | 93% | 2.5 | 16.9 | 93.7 |
| NY | 345 | 6701 | 68% | 3.1 | 20.2 | 93.0 |
| IL | 338 | 4983 | 83% | 2.8 | 22.4 | 96.5 |
| OH | 312 | 4854 | 95% | 2.5 | 21.4 | 97.0 |
| PA | 301 | 5003 | 95% | 3.1 | 21.7 | 97.3 |
| NC | 251 | 5610 | 99% | 3.2 | 15.8 | 97.5 |
| MI | 219 | 3609 | 92% | 2.7 | 18.4 | 97.4 |
| VA | 206 | 3630 | 95% | 2.9 | 20.5 | 96.0 |
| NJ | 192 | 3474 | 95% | 3.6 | 14.4 | 96.8 |
| TN | 189 | 3418 | 96% | 2.6 | 20.7 | 96.3 |
| AL | 173 | 2877 | 99% | 2.7 | 13.6 | 97.5 |
| MD | 169 | 2949 | 91% | 3.1 | 19.0 | 94.5 |
| LA | 168 | 2900 | 90% | 2.9 | 16.0 | 97.6 |
| IN | 154 | 2462 | 96% | 2.7 | 20.2 | 96.9 |
| MO | 149 | 2324 | 85% | 2.6 | 20.2 | 96.1 |
| SC | 149 | 2832 | 100% | 2.9 | 12.5 | 97.1 |
| WI | 123 | 1876 | 89% | 2.8 | 22.7 | 97.4 |
| AZ | 122 | 2302 | 95% | 2.8 | 16.1 | 97.4 |
| KY | 121 | 1767 | 95% | 2.7 | 17.5 | 97.2 |
| MN | 113 | 1470 | 94% | 3.2 | 21.1 | 98.3 |
| WA | 113 | 1780 | 97% | 3.1 | 18.3 | 98.1 |
| MS | 98 | 1980 | 84% | 2.6 | 16.5 | 97.5 |
Quality columns for states with ≥10 facilities; "Not Available" ratings excluded.
Peritoneal dialysis and home hemodialysis shift care out of the facility. Access varies sharply by chain.
56% of facilities report offering PD or home HD (4,056 with PD, 2,397 with home HD training).
Certification dates reveal the sector's expansion wave.
CMS certification year is shown for every facility in the snapshot. The sector grew steadily through the 1980s-2000s; recent years show slower net growth as consolidation replaces expansion.
CMS compares each facility's outcomes to expected ranges. 'Worse than Expected' counts are shown below — these are the outlier signals patients and providers watch most closely.
ZuvFlo Research. (2026, August). US Dialysis Market: Concentration & Quality Atlas, 2026. ZuvFlo. https://www.zuvflo.com/research/us-dialysis-atlas-2026