The Medicare Payment Advisory Commission has recommended that the Centers for Medicare & Medicaid Services delay implementation of its five star rating system for dialysis facilities, which is scheduled to go live on Dialysis Facility Compare in October.
"We urge that CMS delay the implementation of the Dialysis Star Ratings System in order for the agency to issue a proposal to establish the system," the Chairman of MedPac Glenn M. Hackbarth, JD, said in a letter to CMS administrator Marilyn Tavenner. "In its proposal, CMS should describe why the agency believes a second quality measurement system for dialysis facilities—beyond the current QIP—is needed and address the comments they receive."
The letters says MedPAC is concerned "that CMS intends to establish the Dialysis Star Ratings System beginning October 2014 without addressing public comments."
MedPAC also expressed concern that the program's scoring methods and measures differ from the methods used in the ESRD Quality Incentive Program, and "might result in a facility scoring high under one program and low under the other program. Beneficiaries and their families might be confused if a facility’s star and QIP scores diverge."
"Moving to two systems creates greater uncertainty" Hackbarth wrote in the letter. "The Commission generally believes that the measurement of quality performance should be based on absolute standards rather than one calculated from the performance distribution. We believe this is fairer to providers and gives clearer targets for providers to meet. If CMS can establish the need for a Star Ratings System for dialysis facilities, the agency should then describe why it believes the measures in the QIP are an insufficient basis for establishing a Star Ratings Systems. The proposal will also give CMS an opportunity to provide an analysis of the correlation between the ratings calculated under the Dialysis Star Ratings System and the ESRD QIP and explain any discrepancies in measured facility performance between the two measures."
The MedPAC letter also includes comments on the proposed rule released July 2 that would update payment policies and rates under the End-Stage Renal Disease Prospective Payment System and proposes changes to the ESRD Quality Incentive Program for payment year 2017 and PY 2018.