CMS Launches Dialysis Five Star Rankings Program Despite Numerous Flaws, Concerns Expressed By Nation’s Kidney Community

January 22, 2015

Stakeholder Groups Remain Upset Over Agencys Rejection of Numerous Efforts to Collaborate

WASHINGTON, DC – Kidney Care Partners (KCP) reiterated its concern over the Centers for Medicare and Medicaid Services (CMS) decision to launch its five star rankings program using a methodology that distorts the actual quality performance of dialysis facilities, a concern echoed by the country’s leading kidney patient advocacy groups.

“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 and moved to launch the site.”

KCP remains concerned that the program does not reflect the actual quality of care provided. Of particular concern is the statement that “The star ratings show whether your dialysis facility is providing quality care.” Yet, as KCP has consistently noted, the calculation of the scores is based on a forced bell curve, which distorts the actual facility performance.

KCP provided recommendations to CMS to eliminate distortions in the results that will mislead patients and misrepresent the quality of care provided in dialysis facilities nationwide. “We wanted the system to be reliable and meaningful to patients and to reflect the quality of care being delivered,” added Dr. Jones. “The program as developed and now launched by CMS simply does not accomplish that goal.”

Dr. Jones underscored the fact that KCP’s recommendations were focused on methodological improvements that could be made before the Agency’s January 2015 launch deadline. Additional serious problems with data integrity and measure specifications would have to be addressed post implementation.

In recent months, the Medicare Payment Advisory Commission (MedPAC), the independent Medicare advisory committee to Congress, criticized the methodology used by CMS in its ranking system. Additionally, MedPAC questioned the need for the new ranking system altogether, especially since Medicare’s ESRD program already has a fully transparent quality program mandated by Congress, called the Quality Incentive Program (QIP). The QIP provides publicly available information on quality performance that is inconsistent with the new CMS star program.

KCP will closely monitor and collect concerns expressed by kidney care constituencies to share with CMS in an effort to correct the anticipated confusion the site will undoubtedly create among patients, family members, care providers and others.