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DVAC supports policies that promote dialysis vascular access in the ASC and office settings, where the outcomes are superior.


Tell Your Representative to Stop Office-Based Specialty Cuts! Ongoing cuts to office-based specialists under Medicare continue to accelerate the health system consolidation trend, exacerbate health inequities in a variety of diseases, and threaten the pandemic resilience of our healthcare system. 


Working Towards Payment Stability for VAC Centers of Excellence

​In the 2017 Physician Fee Schedule, the Centers for Medicare & Medicaid Services (CMS) cut payments to a key vascular access code by 39%. A survey by the American Society of Diagnostic and Interventional Nephrology (ASDIN) survey in 2017 found that reimbursement levels were so inadequate that more than 20 percent of respondents surveyed stated their centers had closed due to the cuts. More recent Medicare claims data has confirmed a decrease in office-based vascular access services of more than 30 percent since 2017.​ Unfortunately, the 2023 Physician Fee Schedule finalizes yet another round of approximately 15% cuts to office-based vascular access through 2025.


Latest News


DVAC Spotlights the Vital Role of Vascular Access Centers During National Kidney Month, Raises Concerns Over Clinical Labor Cuts


DVAC: Final CMS Rule Puts Dialysis Patients At Risk

Some vascular access specialists may face a 20% cut in the next 5 years


Our Coalition

The Dialysis Vascular Access Coalition (DVAC) is a coalition of medical specialty societies, physicians, and vascular access centers of excellence (VACs) in the office and ASC setting that provide vascular access services to individuals with advanced chronic kidney disease and End-Stage Renal Disease (ESRD). VACs treat more than half of a million cases per year across the country in a safe, specialized, patient-preferred setting.



Vascular access centers of excellence (VACs) serve as specialized, patient-focused, centers dedicated to providing vascular access creation and preservation services in the office or ASC setting.


Fistulas are recognized as the best vascular access option for patients. Conversely, central line catheters have demonstrated high infection rates, high hospitalization rates, and high costs. 


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Washington, D.C. 20001

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