Published by Inside Health Policy
John Wilkerson
September 11, 2014

CMS is delaying the dialysis star rating program, but the dialysis centers and patient advocates that have harshly criticized the program are not happy because CMS plans to use the three-month delay for consumer education and has no plans to change the program.

Trade and patient groups say CMS sprung the star rating program on them without going through public rulemaking, and even the Medicare Payment Advisory Commission complained about the way CMS abruptly created the program without input from dialysis facilities, patients and others. Shortly after CMS announced the dialysis star rating system on its blog in July, dialysis providers and patients criticized the program for grading on a curve and said its metrics were poorly designed and out-of-sync with the end-stage renal disease Quality Incentive Program that has been in place for more than a decade.

“In response to this feedback, CMS has decided to implement the Star Rating System for dialysis facilities in January 2015 to allow more time for consumer education about appropriate use of the ratings for making decisions about treatment,” CMS states in an announcement to providers.

However, industry and patients say a three-month delay without changes is insufficient.

“Contrary to CMS’ announcement, a delay alone is not responsive to the concerns expressed by stakeholders and certainly not to those expressed by DPC,” the Dialysis Patient Citizens state. “While CMS said it was ‘partnering with the ESRD community,’ it has instead declined to consider input on how to design patient-friendly ratings, and ignored DPC’s requests to see consumer testing materials and the geographic distribution of star assignments.”

Edward Jones, Chair of Kidney Care Partners, which represents industry and patients, echoed those sentiments.

“Kidney Care Partners (KCP) believes that no amount of patient education will fix what’s broken in the Dialysis Five-Star Program and by changing the implementation date, CMS has done little more than kick the can down the road,” he said. “Instead of simply changing the implementation date, CMS should start over and develop a rating system that is based on accurate data and an evidence-based methodology.”

Cherilyn Cepriano, executive director of the Kidney Care Council, which represents industry, said CMS could have avoided flaws in the program had it worked with patients and providers. “But today’s announcement makes clear that CMS has no willingness to do so,” she said.

CMS plans to introduce star ratings on dialysis facilities as part of its plan to feature star ratings on all of its consumer-oriented websites to make it easier to compare dialysis facilities, the agency said.

See the original article here.