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Vascular Access Centers

Specialized and Patient-Focused

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

Most VACs operate as physician offices or ambulatory surgical centers (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.


Centers of Excellence

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 VACs specialize in vascular access services, they 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.

Superior Care

Because vascular access centers of excellence (VACs) provide better outcomes and specialized care to ESRD patients, it is essential to maintain and improve patient access to these facilities. A 2017 study in the Journal of Vascular Access reviewed 223,846 Medicare patients on dialysis over a 3-year period with matched cohorts and found significantly better quality and outcomes in the physician office setting. This peer-reviewed study demonstrated that patients treated in the office-based setting have:

Patients treated in the office-based setting have:


Lower Annual Mortality Rates Than HOPD-Based Care



Fewer Infections



Fewer Hospitalizations

DVAC supports Medicare policies that preserve patient access to dialysis vascular access in the office or ASC setting. At hospitals, it often is not possible to receive rapid and effective treatment due to lengthy wait times and, consequently, the use of central line catheters becomes more common. Ultimately, this puts ESRD patients at greater risk of re-hospitalization, infection, and compromised dialysis treatments.

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