The University of Michigan Kidney Epidemiology and Cost Center has released a 207-page report summarizing a two-­day summit held in April aimed at improving the star rating system for dialysis clinics.

KECC formed a technical expert panel, which included patient representatives, dialysis providers, and biostatisticians, and met in Baltimore on April 27-28 to review the rating system.

The meeting was one of the concessions that the Centers for Medicare & Medicaid Services offered to the renal community in light of the heavy criticism of the rating system, which launched in January. Both providers and patient groups, for whom the rating system was created, were openly critical of the methodology used to develop the ratings.

The TEP had two distinct groups that reviewed the rating system and made recommendations. The Public Reporting/Patient and Consumer Understanding work­ group agreed that the rating system, modeled after star ratings for restaurants and hotels, needed to be explained better to patients.

“…The methodology used for the star rat­ings is difficult to understand for intended users (patients and other consumers), and not consistent with other online public rating systems,” the report said. “DFC lan­guage needs to more clearly explain the difference between the DFC Star Ratings reported and other consumer sites such as Yelp, and that the Compare sites are different from other consumer sites that use stars which are based on direct consumer reported satisfaction.

“… CMS needs to decide if the site is intended to assist patients in decision making or if it is intended as a quality improvement effort. Depending on the intended audience, the presentation of the website may be very different. In general, as currently presented, the overall perceived relevance of DFC measures and star ratings for patients/consumers is low,” the workgroup said.

Members of a Methodology Workgroup made sugges­tions to improve the integrity of the website, including “anchor the stars in clinically meaningful terms.” The groups also discussed ways of incorporating patient­ reported outcomes into the star rating methodology.

The complete report is available for download on the CMS website.