The U.S. SNF based dialysis market size was exhibited at USD 3.85 billion in 2023 and is projected to hit around USD 7.05 billion by 2033, growing at a CAGR of 6.23% during the forecast period 2024 to 2033.
The U.S. SNF-based dialysis market has become a pivotal segment of the broader renal care industry, responding to the growing demand for on-site dialysis services among elderly and chronically ill patients residing in Skilled Nursing Facilities (SNFs). As the U.S. population ages and the prevalence of chronic kidney disease (CKD) and end-stage renal disease (ESRD) rises, the healthcare system faces mounting pressure to deliver cost-effective, patient-centric care. SNF-based dialysis models offer a practical and increasingly necessary solution.
SNF-based dialysis refers to the provision of dialysis treatments primarily hemodialysis within the premises of SNFs, eliminating the need for patients to travel to outpatient dialysis centers. This care delivery model significantly enhances patient comfort, reduces hospitalization risks, and contributes to better clinical outcomes. Traditionally, ESRD patients living in SNFs had to endure exhausting and often risky transportation to dialysis clinics multiple times a week. This practice frequently resulted in care fragmentation, missed sessions, and higher readmission rates.
The Centers for Medicare and Medicaid Services (CMS) has played a significant role in shaping this market. Policy shifts towards value-based care, the ESRD Treatment Choices (ETC) model, and increased focus on reducing hospitalizations have further encouraged healthcare providers to explore in-facility dialysis models. Moreover, the financial and operational advantages of integrating dialysis into SNFs—such as reimbursement incentives, reduced transportation costs, and improved patient satisfaction—have been recognized by both providers and payers.
In response, several dialysis providers have entered strategic partnerships with SNFs, developing customized in-house dialysis solutions using portable dialysis machines, mobile dialysis nurses, and dedicated dialysis suites within the facilities. These services align with national objectives of improving outcomes, lowering costs, and enhancing the quality of life for high-risk patient populations.
Increased partnerships between dialysis providers and SNFs to create integrated care pathways and deploy in-facility dialysis solutions.
Growth of mobile dialysis units and portable technology enabling flexible and space-efficient in-SNF treatments.
Policy-driven adoption of SNF-based dialysis, propelled by CMS’s value-based reimbursement initiatives.
Rise in demand for geriatric-focused dialysis protocols, tailored for frail and elderly patients with multiple comorbidities.
Expansion of nephrology service lines by SNF operators, often supported by regional or national nephrology groups.
Digital health integration, including remote monitoring of dialysis sessions and patient vitals to improve clinical oversight.
Improved reimbursement clarity and billing mechanisms that support sustainable SNF dialysis business models.
Growing investor interest in niche dialysis delivery platforms focused on long-term care and post-acute settings.
| Report Coverage | Details |
| Market Size in 2024 | USD 4.09 Billion |
| Market Size by 2033 | USD 7.05 Billion |
| Growth Rate From 2024 to 2033 | CAGR of 6.23% |
| Base Year | 2023 |
| Forecast Period | 2024-2033 |
| Segments Covered | Region |
| Market Analysis (Terms Used) | Value (US$ Million/Billion) or (Volume/Units) |
| Regional Scope | U.S. |
| Key Companies Profiled | Genesis Healthcare; Brickyard Healthcare (Formerly Golden LivingCenters); Plaza Healthcare; Carespring; Generations Healthcare Network; Arbors Of Ohio; MediLodge; The Alden Network; Avalon Health Care; Batavia Nursing Care Center |
One of the most powerful drivers for the U.S. SNF-based dialysis market is the rapidly aging population coupled with a growing ESRD burden. According to the U.S. Renal Data System (USRDS), nearly 800,000 Americans live with ESRD, and this number continues to rise annually. A significant portion of this population is over the age of 65, with many requiring long-term care in SNFs.
Traditional dialysis settings often fail to address the unique needs of elderly patients who face mobility challenges, cognitive decline, and multi-morbidity. Transporting these patients to outpatient centers is not only logistically taxing but medically risky. SNF-based dialysis provides a clinically appropriate alternative, offering on-site, nurse-supervised sessions, which are better synchronized with the patient's comprehensive care plan. This patient-centric approach is now viewed as a critical necessity rather than an optional enhancement in geriatric nephrology care.
Despite its advantages, a key restraint in the U.S. SNF-based dialysis market is the limited infrastructure and skilled staffing within many SNFs to support in-house dialysis services. Establishing dialysis suites requires not only capital investment in dialysis equipment but also compliance with stringent infection control and water treatment standards.
Additionally, the staffing challenge looms large. SNFs often struggle with high turnover rates among clinical personnel, and training existing staff to manage dialysis protocols can be resource-intensive. Moreover, the recruitment of nephrology-trained nurses and technicians for on-site dialysis delivery may pose logistical hurdles, particularly in rural or underserved regions. These challenges often deter smaller SNFs or independent facilities from adopting this care model, despite its evident clinical benefits.
An emerging opportunity lies in the alignment of SNF-based dialysis with CMS’s value-based care goals, particularly the ESRD Treatment Choices (ETC) model launched in 2021. This model incentivizes providers to increase the use of home dialysis and transplant options, but also indirectly supports SNF dialysis by rewarding reduced hospital admissions, improved outcomes, and better coordination.
SNFs that adopt in-house dialysis models are well-positioned to contribute to these metrics. In doing so, they can benefit from shared savings programs, enhanced Medicare Advantage coverage, and bundled payment incentives. Moreover, integrated SNF-dialysis models can collaborate with Accountable Care Organizations (ACOs) and nephrology groups to optimize care pathways and reduce total cost of care. This policy alignment makes SNF-based dialysis not just a clinical innovation but a financially viable one.
The Northeast region dominated the U.S. SNF-based dialysis market, owing to its high density of SNFs, well-established nephrology networks, and mature post-acute care infrastructure. States like New York, New Jersey, and Massachusetts have been early adopters of in-facility dialysis programs. Urban centers such as New York City and Boston have SNFs with affiliations to academic medical centers and access to mobile dialysis vendors, which facilitate implementation. Furthermore, regulatory support and payer readiness in the Northeast have made it feasible for SNFs to partner with dialysis providers to create hybrid care models. These models often include dedicated dialysis wings, portable machines, and frequent nephrologist visits—reducing patient hospitalization rates and enhancing continuity of care.
The Southeast region is the fastest-growing segment, driven by a rapidly aging population, high ESRD prevalence, and increasing investments in long-term care facilities. States such as Florida and Georgia are experiencing a surge in retirees and elderly residents, many of whom have chronic conditions requiring ongoing renal support. With a large Medicare population and increasing CMS scrutiny on hospital readmissions, SNFs in the Southeast are adopting dialysis partnerships to strengthen their clinical offerings. Companies such as Dialyze Direct and Concerto Renal Services have expanded their footprint in this region, focusing on deploying turnkey SNF dialysis solutions. These include staff training, waterless dialysis systems, and electronic health record (EHR) integration to streamline nephrology reporting.
Within the U.S., several macro-level trends are influencing the adoption of SNF-based dialysis, including healthcare consumerism, managed care expansion, and value-based purchasing reforms. Nationally, over 1.5 million individuals reside in SNFs, and a growing share of these patients are either undergoing dialysis or are at risk of renal decline. SNFs that can provide co-located dialysis services not only reduce the physical burden on patients but also improve facility reputation, case mix, and financial performance under Medicare’s Skilled Nursing Facility Value-Based Purchasing Program.
The federal government has also provided a regulatory tailwind through clarified billing codes, payment models such as Medicare Part B coverage for dialysis in SNFs, and support for renal care transformation through demonstration projects. Additionally, private insurers and Medicare Advantage plans are increasingly partnering with vertically integrated providers to reduce avoidable hospitalizations linked to dialysis-related complications. This has encouraged private equity investments in platforms that specialize in SNF-based dialysis delivery, aiming to capture value across the continuum of care.
In February 2025, Dialyze Direct, one of the leading providers of SNF-based dialysis services, announced a multi-state partnership with a large national nursing home chain to implement waterless dialysis technology in over 100 facilities. The goal is to improve access and reduce operational overhead for facilities that lack plumbing infrastructure for traditional dialysis.
In December 2024, Concerto Renal Services expanded its operations to Texas and the Carolinas, reinforcing its mission to build integrated renal care programs within skilled nursing settings. The expansion included the launch of new mobile dialysis units and in-house nephrology support teams.
In October 2024, US Renal Care piloted a collaborative SNF-dialysis initiative in California, combining mobile dialysis nurses with tele-nephrology consults. The program demonstrated a 25% reduction in hospital readmission rates and gained attention from Medicare Advantage partners.
In August 2024, Fresenius Medical Care began testing AI-enabled remote monitoring systems for dialysis patients in SNFs. The pilot aims to optimize fluid management and early detection of adverse events, thus aligning dialysis care with broader SNF clinical operations.
This report forecasts revenue growth at country levels and provides an analysis of the latest industry trends in each of the sub-segments from 2021 to 2033. For this study, Nova one advisor, Inc. has segmented the U.S. SNF based dialysis market.
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