Take note tomorrow when the October jobs report is released. Printed on a lag, the ESRD jobs number is still instructive. The first question is may answer is whether DVA's churn subsided at the end of the 3Q. Probably not, but let's be optimistic.
The second question is what was the total number of employed? The dialysis industry is so inflexible that declines in employed individuals translates into declines in average treatments per day. There is simply no way to make a service that requires 3-4 hours of treatment go any faster without risking the health of the patient. In that event, another problem emerges, missed treatments and higher mortality.
Consistently, employees of dialysis center perform about 1.4 treatments per day and there is not a whole lot that can be done to improve upon that. Yes, home dialysis will help but after years of centralization of treatment with incentives for nephrologists to preserve that system, care migration will not be easy.
If recent history is a guide and the JOLTS data is any indication, the employed at ESRD facilities should show further retreat in the September print. Any gains reported in 4Q are likely to follow the "lower high" pattern we have seen in recent months.
We cover this problem and more on a quick call today. Link here for replay.
Emily Evans
Managing Director – Health Policy
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