Dialysis centres · Healthcare
Per-session cost and scheme receivables for dialysis centres, measured centre by centre
A dialysis centre runs the same treatment many times a day. Its economics come down to the cost of one session, the number of sessions each machine runs, and how quickly each payer settles. We measure all three, centre by centre.
In one paragraph
Dialysis chains and standalone centres, usually with five to two hundred machines across several locations and ₹10–250 crore turnover, run their own centres, units inside partner hospitals, or centres under public-private partnership. Their business is repetition. Patients return two or three times a week for years. Small differences in per-session cost and payer terms therefore compound across a very large number of sessions, and founders and finance heads need them measured.
Founder or chief executive, often with the finance head
The economics
How the money moves in this trade
The cost of a session is mostly the dialyser and bloodline set, dialysis fluid and concentrate, drugs given during the session, and technician and nursing time. The machine and water-treatment plant that support it add the rest. Whether dialysers are single-use or reprocessed changes consumable cost materially. Machine capacity is set by the number of shifts each machine can run in a day, so utilisation decides how far fixed cost is spread.
Payers vary widely. Some patients pay directly, and many are covered by government schemes, public-sector employers or insurers. Centres under public-private partnership are paid by a government body under the terms of the contract. Units inside partner hospitals often share revenue with the hospital. Each payer has its own rate, documentation and settlement timetable, so a centre that looks busy can still be short of cash.
The problem
Where the numbers usually break down
Per-session cost is not known
Consumables and drugs are expensed in bulk, so the cost of a session at each centre — and the effect of reprocessing dialysers — is never measured.
Machine utilisation is not reported
Shifts run per machine per day are known to the centre manager but not reported, so idle capacity and the case for new machines are both guesswork.
Scheme dues are aged as one balance
Government-scheme and partnership receivables are held as a single figure, without ageing by payer, month of service or claim status.
Hospital revenue-share is not reconciled
Units inside partner hospitals settle revenue share on figures prepared by one side, and differences are carried forward rather than resolved.
Consumables stock at centres drifts
Dialysers, bloodlines and drugs held at many small centres are counted rarely, so usage cannot be matched to sessions recorded.
What we do
The work, and the result each part produces
Per-session costing
Dialyser, bloodline, fluid, drugs, staff, machine and water-plant cost per session, by centre and by reprocessing practice.
Every centre has a known cost per session.
Machine utilisation reporting
Sessions run against available shifts for each machine and centre, monthly.
Capacity decisions rest on actual use.
Payer-wise receivables
Dues aged by payer, centre and month of service, with claim submission, queries and deductions tracked.
Collection effort goes to the payer and the month that need it.
Partnership and revenue-share reconciliation
Sessions, billing and revenue share reconciled with each partner hospital or contracting body every month.
Partner settlements are agreed, not carried forward.
Consumables reconciliation by centre
Consumables issued and on hand reconciled with sessions recorded at each centre on a fixed cycle.
Consumable usage matches the sessions delivered.
New centre and machine appraisal
Expected sessions, payer mix, rates and per-session cost modelled for each proposed centre or machine.
Expansion follows centres that will pay back.
Where we start
The first steps of an engagement
Session logs and payer ledgers
We ask for session registers by centre and machine, consumable and drug issues, dialyser reprocessing records, the payer-wise claims and receivables ledger, and revenue-share statements with partner hospitals.
Cost per session by centre
We cost a session at each centre from dialyser, bloodline, fluid, drugs, staff, machine and water-plant cost. Single-use and reprocessing practice are shown separately.
Receivables aged by payer
Dues are split by payer, centre and month of service. Claim submission, queries and deductions are tracked so each stuck claim has an owner.
Centre cost and receivables report
The first report shows cost per session and machine utilisation by centre, receivables by payer and month of service, and partner revenue share reconciled.
How it is measured
The reports the work is judged on
Each is recorded as a baseline before the work starts, so later reports have an honest comparison.
- Cost per session, by centre
- Machine utilisation against available shifts
- Receivables by payer, centre and month of service
- Partner revenue share reconciled monthly
- Consumables used against sessions recorded
- Contribution by centre and payer
Who it suits
Written for, and not the right fit for
- You need advice on clinical protocols, dialyser reprocessing practice on clinical grounds or centre registration; those sit with your nephrologists and the relevant authorities.
- You need a statutory audit or tax-audit report for the dialysis business on its own — that is signed by an independently engaged CA.
- Dialysis chains with centres across several cities or districts.
- Operators running units inside partner hospitals or under public-private partnership.
- Chains preparing to add machines, open centres or raise investment.
Services
Services this work draws on
Costing and profitability
What each product, line and customer really contributes.
Explore service ↗Internal controls and risk
Controls sized to your business, documented and actually tested.
Explore service ↗Outsourced accounting
Your books kept current and reconciled, closed to a published calendar.
Explore service ↗MIS and financial planning
Reporting built around the questions you actually need answered.
Explore service ↗Every other service, also available in this trade
Common questions
Questions owners in this trade ask
Does reprocessing dialysers change the cost per session?
Yes, materially, and it varies by centre. Whether to reprocess is a clinical decision; we simply show the cost effect of each practice so it's visible.
Can you help us collect scheme dues faster?
We can show exactly what's outstanding by payer and month, which claims are stuck and why. Clean, complete claim documentation is usually what speeds settlement.
Do you work with dialysis units inside partner hospitals?
Yes. Reconciling sessions and revenue share with the partner hospital each month is often the most useful single piece of work for those units.
5th Quadrant performs costing, receivables, reconciliation and reporting work. Clinical decisions, clinical establishment registration and the terms of any government contract are the operator's own responsibility with its clinicians and the relevant authorities. Statutory audit and tax-audit reports are performed by independently engaged licensed professionals. Full detail is on our Professional Scope page.
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