Kidney-care providers are still battling methods used by the CMS to help dialysis patients evaluate quality at more than 5,500 U.S. treatment centers. The ratings are difficult to understand and are not consistent with other online public-rating systems, a technical expert panel said in a report released Tuesday.
The analysis comes as the providers await the release this month of the newest round of one- to five-star quality ratings, which are meant to summarize how well the facilities did on measures such as reducing hospitalizations, blood transfusion and deaths, among other concerns. In January, the CMS began publicly posting the stars on its Dialysis Facility Compare amid industry protests.
The CMS said it would continue plans to annually post ratings and add new measurements, despite ongoing criticisms. Meanwhile, studies have shown that many of the more than 400,000 hemodialysis patients in the U.S. continue to receive substandard care despite widely accepted best practices.
Patients whose kidneys stop working require dialysis—a process to filter toxins from their body—three times a week for several hours at a time. Though not perfect, the star ratings are good motivation to spur needed change and boost quality among these chronically ill patients, advocates say.
The report released Tuesday summarizes recommendations from a technical expert panel, which met in April to discuss the rating program for the dialysis facilities. The 18-member panel included representatives from the two largest U.S. kidney-care providers, DaVita and Fresenius.
The work group stated that language used on the Dialysis Facility Compare website needs to be clearer. Compare sites are different from other consumer sites that use stars, which are based on direct consumer reported satisfaction, according to the report. “CMS needs to decide if the site is intended to assist patients in decisionmaking or if it is intended as a quality improvement effort,” the report said. As currently presented, the relevance of the measures and star ratings for consumers “is low.”
The panel also recommended against continuing with curved rankings, which providers say has “inherent flaws.” Under current methodology, a predetermined percentage of facilities fall under each star category. For example, only facilities in the top decile can receive the full five stars.
Dialysis facility star ratings will be updated on an annual basis beginning in October 2015, the CMS says on its website. Similar star ratings are also publicly displayed on the agency's nursing home, home health, physician, Medicare advantage plan and hospital compare websites.
