Dialysis Facility Compare (DFC) is an online tool that allows users to search and compare dialysis facilities based on star ratings and certain measures. DPC has previously submitted suggestions on how to improve the proposed measures. Recently, the Centers for Medicare and Medicaid Services (CMS) announced in a Planned Changes document that the star ratings included in the DFC would be reassigned based on a 2014 threshold, meaning that the distribution of ratings would look more like it does on CMS’ other websites, and apply standards that are more familiar and intuitive to consumers. DPC submitted another comment letter to CMS, applauding the apparent openness to a new star rating methodology.
A key feature of CMS’ current star ratings structure is a bell-curve grading that limits 4- and 5-star ratings to facilities ranked in the top 30 percent, and forces the bottom 30 percent into 1- and 2-star ratings. No other federal website that uses star ratings issues as many 1- and 2-star ratings, and some do not bestow such low ratings at all. It appears that CMS has retreated from insistence on treating dialysis clinics differently from hospitals, nursing home, and health plans.
DPC’s letter emphasizes that “maintaining a degree of stability in the star ratings must be a key consideration” in order to keep consumers’ confidence in the DFC’s accuracy. This year 2,500 facilities’ ratings were changed, and for every facility that increased in ratings another facility’s rating was lowered, regardless of its performance. DPC argues that downgrading ratings should only apply to facilities that have experienced an actual drop in performance quality; a feature that is included in CMS’ Planned Changes. DPC will continue to monitor CMS’ activities on this patient tool and report any updates in the future.