The Shift Toward Hybrid and Home-Based Care
A major trend in 2026 is the role of the center as a training and support hub for home dialysis. While in-center treatments still account for about 80% of sessions globally, the "Home-First" policy—accelerated by reimbursement parity in the US and Europe—has turned centers into classrooms.
Patients spend their first few weeks at a center learning how to operate portable hemodialysis units or automated peritoneal dialysis (APD) cyclers before transitioning to home care.
The relationship between the patient and the center has become "hybrid." Patients dialyzing at home remain connected to the center via tele-nephrology platforms. In 2026, a center’s command station may oversee 50 in-center patients and 100 home-based patients simultaneously. This model has allowed large dialysis organizations (LDOs) to reduce overcapacity in physical buildings while expanding their reach into rural areas through remote monitoring and mobile technician support.