American Renal Associates Announces Outstanding Quality and Satisfaction Results

ARA's Strength of Core Values and Unique Physician-Partnership Model Delivers Superior Patient and Physician Satisfaction Compared with National Averages

American Renal Associates Holdings, Inc. ARA ("ARA" or the "Company"), a leading provider of outpatient dialysis services, today announced that the Company continues to build on its exceptional track record of sustained outperformance in the areas of patient quality and patient satisfaction, as well as physician satisfaction, based on recently released results issued by the Centers for Medicare & Medicaid Services ("CMS") end-stage renal disease ("ESRD") Quality Incentive Program ("QIP"), as well as others.

Joseph (Joe) Carlucci, Chairman and Chief Executive Officer, said, "These outstanding results reflect the strength of our operating model, the patient-centric culture of our organization and our unwavering commitment to sustaining an environment that promotes high-quality patient care and physician satisfaction. We are proud to report continued outperformance in the areas of quality and satisfaction, and we look forward to continuing to share these results with our key stakeholders so they can appreciate the benefits of our operating model."

ARA's QIP performance remains consistently higher than the national average. ARA is fulfilling its commitment to provide patients with high-quality care, as its QIP performance remains consistently higher than the national average. QIP data from 2016, the most recent performance year, show that only 10.5% of ARA's facilities with a QIP score will receive a payment reduction for payment year 2018, as compared to the national average of 14.2% of facilities that will receive a payment reduction for 2018. Over the past four performance years of the QIP program, ARA's facilities have consistently exceeded the national average as a result of the Company's dedication to providing high-quality care that is clinically integrated with the practice of its local physician partners.

Most recent 2017 ICH-CAHPS performance again demonstrates higher levels of satisfaction among ARA dialysis clinic patients. The CMS In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems ("ICH-CAHPS") survey is conducted semi-annually and provides insight into how satisfied dialysis patients are with their care. During Q4 2017, ARA received strong results from the ICH-CAHPS survey conducted in mid-2017. Specifically, ARA's performance was rated 13%, 11% and 10% higher than the national averages in terms of how satisfied patients were with the dialysis clinic, the dialysis clinic staff and the nephrologist associated with the facility where patients receive their care, respectively.

ARA's Core Values prioritize patient care and foster a collaborative environment with physician partners that empower staff to provide the best possible care for patients. As a result, ARA enjoys low voluntary clinic staff turnover in comparison to many other healthcare service providers, with year-end 2017 clinic staff turnover of 7.8%. ARA believes that dialysis patients appreciate the continuity of their local clinic staff caregivers, and recognize that having experienced, stable staff can contribute to better health outcomes.

ARA's annual voluntary physician satisfaction survey results highlight superior performance with physician stakeholders. For the third consecutive year, ARA conducted a voluntary physician survey that was administered by Press Ganey Associates, Inc. The most recent 2017 physician satisfaction survey results placed ARA in the 99^th percentile for physician alignment and engagement, which are key measures of satisfaction among clinic doctors and indicate the clinician's sense of pride and intention to remain affiliated with their ARA clinic. ARA's physician satisfaction, as measured by the number of top box score responses, was in the 98^th percentile or above in a number of key areas such as the physician's satisfaction with their input into clinical decisions, the quality of patient care and ARA leadership.

"As we reflect on the success of our operating model, and the continued progress that the entire dialysis industry has made with respect to improving patient outcomes, as evidenced by CMS data, we join other leading providers in endorsing The Dialysis Patient Access to Integrated-care, Empowerment, Nephrologists and Treatment Services (PATIENTS) Demonstration Act. We believe that integrated kidney care—led by nephrologists and care teams that can employ the dialysis clinic as the patient's medical home—can lead to even better dialysis outcomes, greater access to transplants and lower costs to the Medicare program," concluded Carlucci.

About American Renal Associates

American Renal Associates Holdings, Inc. ARA is a leading provider of outpatient dialysis services in the United States. As of September 30, 2017, ARA operated 217 dialysis clinic locations in 25 states and the District of Columbia serving approximately 15,200 patients with end stage renal disease. ARA operates through a physician partnership model, in which it partners with approximately 400 local nephrologists to develop, own and operate dialysis clinics. ARA's Core Values emphasize taking good care of patients, providing physicians with clinical autonomy and operational support, hiring and retaining the best possible staff and providing best practices management services. For more information about American Renal Associates, visit www.americanrenal.com.