MedPAC Advises CMS To Delay Dialysis Star Rating System

Published by Inside Health Policy
John Wilkerson
August 19, 2014

Echoing provider and patient complaints, congressional Medicare advisers say CMS should delay the looming dialysis star rating system until it can get public feedback and justify a second-quality measure system. However, a dialysis provider representative said CMS officials recently told providers and patients that they do not plan to delay the October start date.

Shortly after CMS announced the dialysis star rating system on its blog in July, dialysis providers and patients started complaining that the agency should have sought input from the public before springing the ill-conceived program on them. They criticized the program for grading on a curve and said its metrics are 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.

The Medicare Payment Advisory Commission hits on those same points in an Aug. 15 letter to the agency.

“We urge that CMS delay the implementation of the Dialysis Star Ratings System in order for the agency to issue a proposal to establish the system,” MedPAC states. “In its proposal, CMS should describe why the agency believes a second quality measurement system for dialysis facilities — beyond the current QIP — is needed and address the comments they receive.”

CMS should make quality measurements simpler and clearer, MedPAC writes, yet CMS is proposing a second quality measure system that grades differently, uses some metrics that differ from the QIP and will end up scoring the quality of dialysis facilities differently.

“The differences in the methods and measures might result in a facility scoring high under one program and low under the other program,” MedPAC states.
Also, MedPAC believes CMS should rate performance based on absolute standards, instead of the bell curve approach taken in the dialysis star rating system.
“If CMS can establish the need for a Star Ratings System for dialysis facilities, the agency should then describe why it believes the measures in the QIP are an insufficient basis for establishing a Star Ratings System,” MedPAC states.

See the original article here.