5 Star Ratings

Dialysis Patient Citizens (DPC) has taken the lead in seeking improvements to the Dialysis Facility Compare star rating system. Under the current methodology, all dialysis clinics across the U.S. are ranked against one another, with stars assigned by dividing the facilities into five tiers. Under this system, the bottom 10 percent are given one star, and those in the next twenty percent (11th percentile to 30th percentile) given two stars.

DPC objects to this methodology for several reasons.

First, a nationwide competition among all facilities that gives considerable weight to health outcomes (such as hospitalizations and mortality) disfavors facilities in places where, in general, patients are less healthy. Dialysis Facility Compare star ratings are most favorable to clinics in healthy states, such as Hawaii and Colorado, but unfavorable to clinics in places like West Virginia. This discourages investment in clinics in places that need them the most.

Second, consumers associate one- and two-star symbols with poor quality, such as bad movies or budget motels. CMS did not draw upon consumers’ existing experience with star ratings, instead substituting its own bell-curve system that stigmatizes providers who don’t deserve it.

Finally, most observers, including the Medicare Payment Advisory Commission, believe quality ratings should be based upon absolute standards, not tournaments among providers. DPC is committed to working with other kidney care stakeholders to develop an alternative system for assigning stars.

The links below will take you to documents that more fully describe the Dialysis Facility Compare star rating system and its limitations.

Archive of CMS Contractors’ Reports

View DPC’s Patient Education Fact Sheet

Read DPC’s letter to the CMS Chief Medical Officer

Read coverage from InsideHealthPolicy.com

Read coverage from Nephrology News and Issues

Read DPC’s Request for Correction complaint to CMS

Read the Request for Correction’s appendices

December 1, 2015 – DPC’s Feedback Letter to CMS about Proposed Measures for Dialysis Facility Compare

April 23, 2019 – DPC’s Letter to the California Assembly About Quality Ratings

Related Information

Happy Holidays and DPC’s Top 10 Accomplishments of 2019

December 20th, 2019|Categories: 5-Star Ratings, About DPC, Access to Transplant, Article, Care Coordination, Charitable Premium Assistance, Dental Coverage, Dialysis Funding, Immunosuppressive Drug Coverage, Innovation, Medicaid, Medicare Advantage, Medigap Coverage, Quality Incentive Program, Transplant Donor Protection, Transportation Services, Treatment Options|

Dialysis Patient Citizens wants to wish you and your family a Happy Holiday, as well as a safe and healthy New Year. Our offices will be closed for the holidays starting December 23 through January 1. [...]

2015 Year in Review

January 19th, 2016|Categories: 5-Star Ratings, Access to Transplant, Article, Care Coordination, Charitable Premium Assistance, Dialysis Funding, Innovation, Medicare Advantage|Tags: |

Happy New Year!  In 2015, DPC leadership and its strong patient advocacy efforts at the state level fought to: prevent dramatic cuts to dialysis funding in Alabama and Illinois and preserve charity payments for [...]

Learn More About Increasing Quality of Care

hemodialysis room equipment

Dialysis Funding

Artificial kidney (dialysis) device with rotating pumps. Closeup view.

Quality Incentive Program

five stars/Health care concept

5 Star Ratings