Kidney Coalition Calls on CMS to Address Serious Flaws in ESRD Five-Star Program Before Implementation

Today, the Centers for Medicare and Medicaid Services’ (CMS) announced plans to change the implementation date of its Dialysis Five-Star Rating System from October 1, 2014, to January 2015. The Agency says it plans to use the time ‘for consumer education about appropriate use of the ratings for making decisions about treatment.’ There is no indication that CMS plans to correct flaws in the program, despite the serious concerns raised collectively and individually by patient advocates, physician and nursing organizations, dialysis providers, as well as policy makers, including Medicare Payment Advisory Commission (MedPAC).

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. 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.

As MedPAC noted, the Medicare ESRD program already has an existing, fully transparent quality program mandated by Congress, called the Quality Improvement Program (QIP). This program provides publicly available quality information at the facility level.

We urge CMS leaders to work closely with the kidney care community to find an alternative to the current forced ‘bell curve’ methodology. We also urge the Agency to work with us to ensure that the quality measures included in the program lead to public information about dialysis that is accurate, evidence-based, useful and understandable for patients and the general public.

This Five-Star program simply should not move forward given its numerous flaws.