Kidney Care Partners and the Kidney Care Council are concerned that the Centers for Medicare & Medicaid Services has decided to continue with its Dialysis Facility Compare Star Rating methodology, according to statements released by the groups.

CMS announced Nov. 7 that it had considered the comments and concerns presented by the renal community, but that it had decided to continue with the rating system without changing its methodology.

Kidney Care Partners, which represents patient advocates, clinicians, care professionals, dialysis providers, researchers and manufacturers, said CMS’ methodology for the star rating system for dialysis providers “distorts the actual quality performance of dialysis facilities.”  But CMS has stood by its rating system, which is set to go live on Dialysis Facility Compare in January.

“KCP has long supported quality measurement and transparency as a means to drive improvement in patient outcomes,” said Chairman Dr. Edward Jones, a practicing nephrologist.  “As a community, we have walked the walk by developing quality measures, launching care improvement initiatives, and supporting the first true pay-for-performance system.  So, we find it deeply troubling that CMS officials would signal their willingness to work with us on short-term improvements to this star-based ranking system and then summarily dismiss our recommendations—all without the benefit of discussion.”

The Kidney Care Council, which represents dialysis providers, also released a statement expressing concern about CMS’ decision. “Since we first learned of the intent to create a Dialysis Star Rating System, we have sought to work with Medicare as good partners to get the program right.” said Cherilyn Cepriano, KCC executive director. “KCC is disappointed that Medicare has chosen to ignore the constructive feedback of the kidney community and to implement a Dialysis Star Rating System built with inappropriate measures, based on inaccurate data, and using a flawed methodology.”

In August, the Medicare Payment Advisory Commission (MedPAC) advised CMS to delay implementation of the star rating system in order for the agency to issue a proposal to establish the system. In it’s report, MedPAC  said “the Commission believes the quality measurement process needs greater simplicity and clarity. Moving to two systems creates greater uncertainty. Furthermore, the commission generally believes that the measurement of quality performance should be based on absolute standards rather than one calculated from the performance distribution.” CMS did delay implementation, which was originally set for October 2014, but did not make any changes to its quality measures, despite recommendations from the renal community. Kidney Care Partners said it convened community leaders, quality measurement experts, and academicians to develop and present recommendations.

“We want the system to be reliable and meaningful to patients and to reflect the quality of care being delivered,” said. Jones. “The program as developed by CMS simply does not accomplish that goal.”


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