Providers at non-hospital vascular access centers (VACs) play a critical role in providing vascular access services to patients with end-stage renal disease (ESRD) so that they may receive dialysis treatments, without which they would not survive. VACs serve as specialized, patient-focused, facilities dedicated to providing vascular access creation and preservation services outside of the hospital.
Prior to beginning dialysis, patients must undergo minor surgery to create an access to the bloodstream where needles may be placed to perform dialysis treatment. At these non-hospital facilities, specialized surgeons:
- Create permanent vascular accesses
- Preserve and maintain vascular accesses
Most VACs operate as physician offices or ambulatory surgical center (ASCs) and are voluntarily accredited by nationally recognized bodies. They are typically reimbursed for services by Medicare under either the Physician Fee Schedule or the Ambulatory Surgical Center Prospective Payment System Fee Schedule.
Non-hospital VACs are critical for treating patients with ESRD because they provide patient-focused services from practitioners who are highly specialized in the field of vascular access. Since they are located at freestanding offices that specialize in vascular access services, VACs understand the importance of avoiding lengthy hospital delays or wait times. Streamlining of services is vital for ESRD patients, since vascular access repair must be done within a short window of time in order to avoid failure or irreparable loss of the vascular access. For many patients, mere hours matter. If vascular access is not restored quickly after a failure, the risk of infection, hospitalization, or mortality significantly increases.
VACs demonstrate better patient outcomes and are more cost-effective than hospital outpatient departments (HOPDs), in part because they are more specialized in creating and maintaining fistulas.