“We want the system to be reliable and meaningful to patients and to reflect the quality of care being delivered,” said Chairman Dr. Edward Jones, a practicing nephrologist. “The program as developed by CMS simply does not accomplish that goal.”
The Kidney Care Council also issued a statement expressing its disappointment, saying CMS has chosen to implement a system “built with inappropriate measures, based on inaccurate data, and using a flawed methodology.” The group criticized the methodology for including measures not focused on dialysis services, such as all-cause hospitalizations. The results to come in January will be confusing for patients and offer conflicting standards for providers, the council said.
Use of the ratings on the agency's Dialysis Facility Compare website is intended to help Medicare beneficiaries compare the quality of care they can expect at centers across the country. CMS revealed the methodology in July. It includes nine publicly reported quality measures, such as standardized ratios for transfusions, mortality and hospitalizations, and percentages for KtV values, which show whether enough waste was removed from the patient's blood during dialysis. The ratings also will reflect percentages of adult dialysis patients with high calcium levels. Some measures will be weighted more heavily than others.
Dialysis providers immediately argued the end-stage renal disease quality incentive program and Medicare's survey process already assess the same factors. The rollout had been scheduled for October but was delayed amid complaints from providers. However, late Friday the CMS said it had reviewed the feedback provided, but the program would maintain the original methodology.
The CMS will issue a public call for a technical expert panel in the coming months. That group will be charged with evaluating the methodology and recommending future modifications, the agency said. Kidney groups said that process should happen first, before the rollout.
All dialysis facilities participating in Medicare will have 15 days to review the data and star ratings issued by CMS Friday, before the material is posted on the CMS website in January. The deadline for submitting comments, including questions about the accuracy of a facility's rating, is Nov. 24. Data will then be updated on an annual basis beginning in October 2015, the CMS said.
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