Fwd: MEDICARE NEWS - Medicare Publishes New Information on Quality of Care at Dialysis Facilities

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Date: Thu, 20 Nov 2008

15:29:21 -0500

Reply-To: " Austin, Annetta V.

(CMS/OEA) "

Sender: CMS PRESS RELEASES AND FACTS

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MEDICARE

NEWS

For Immediate

release

November 20,

2008

Medicare Publishes New Information on Quality of

Care at Dialysis Facilities

Changes to Web Site Will Help Consumers Compare Care and Make

Informed Health Care Choices

The Centers for Medicare & Medicaid Services (CMS) today announced

important additions to the Dialysis Facility Compare consumer Web

site

(

http://www.medicare.gov/dialysis) that will give consumers even

better insight into the quality of care provided by their local dialysis

patient facilities.

The improvements include two new quality measures that demonstrate how

well dialysis patients are treated for anemia (low red blood cell count)

as well as updated information that will help patients better understand

survival rates by facility.

Dialysis Facility Compare links consumers with detailed

information about the 4,700 dialysis facilities certified by Medicare,

and allows users to compare facilities in a geographic region.

Users can review information about the size of the facility, the types of

dialysis offered, the facilities’ ownership, and whether the facility

offers evening treatment shifts.

Consumers can also compare dialysis facilities based on three key quality

measures­ how well patients at a facility have their anemia under

control, how well patients at a facility have waste removed from their

blood during dialysis, and whether the patients treated at a facility

generally live as long as expected. Dialysis Facility

Compare also links users to resources that support family members and

specialized groups of kidney patients.

“Dialysis Facility Compare is yet another tool that equips

consumers with the tools they need to seek better, value-based health

care,” said CMS Acting Administrator Kerry Weems. “Adding more

information on the Dialysis Facility Compare Web site about

anemia­a condition that affects many dialysis patients­and patient

survival will help us all learn more about how well the country’s

dialysis facilities are serving Medicare beneficiaries and the entire

health care system.”

Dialysis Facility Compare has featured information about

anemia control since the Web site was launched in 2001.

Historically, the Web site has shown the percentage of patients in a

facility whose hematocrit levels were at 33 percent or more (or

hemoglobin levels of 11 g/dL or more), based on clinical practice

guidelines at the time. However, recent evidence about increased

risk of certain adverse events associated with the use of erythropoiesis

stimulating agents (ESAs), which are used to treat anemia, has raised

concerns about patients who hemogloblin levels are too high as well as

patients whose hemoglobin levels are too low. The Food and Drug

Administration has responded by requiring manufacturers to develop a

Medication Guide and to ensure that this information is provided to

patients. As a result, Dialysis Facility Compare will now

feature two anemia measures­one measure will show the percentage of

patients whose hemoglobin levels are considered too low (i.e., below 10

g/dL) and a second measure will show the percentage of patients whose

hemoglobin levels are considered too high (i.e., above 12 g/dL).

“These two new measures better reflect recent medical evidence about the

challenges of managing anemia,” said CMS Chief Medical Officer and

Director of the agency’s Office of Clinical Standards & Quality,

Barry Straube, M.D. “Our new measures will help patients and health care

providers to better understand how a facility’s patients are treated for

anemia, a condition for which studies have shown that over- and

under-treatment can affect patients’ health status and quality of

life.”

In to

adding new information about anemia treatment, CMS has also updated the

way it reports patient survival rates on Dialysis Facility

Compare. Since 2001, CMS has reported survival rates by

comparing a facility's expected patient survival rate to its actual

patient survival rate. (The expected survival rate takes into account the

patients’ personal characteristics, health, and dialysis history.

The actual survival rate is the rate each facility reports to CMS about

how many patients have survived in a given timeframe.) Facilities’

survival rates were then rated as belonging to one of three categories:

“Better than Expected” (by 20 percent or more), “As Expected” or “Worse

than Expected” (by 20 percent or more). This method of calculating

patient survival resulted in a finding of “As Expected” for 94 percent of

dialysis facilities nationwide, with only 3 percent in the “Better” or

“Worse” categories, respectively.

To

help consumers make better distinctions among facilities’ survival rates,

CMS updated the statistical method it used to classify facilities in the

three categories. While consumers will continue to see facilities

placed into one of these categories, they will find fewer facilities in

the “As Expected” category, and more facilities in the “Better” or

“Worse” categories.

Today’s enhancements are only one part of CMS’ plans to improve the

quality of care in America’s dialysis facilities. Earlier this

year, CMS revised its conditions for coverage regulations for the first

time in over 30 years, which updated the health and safety standards that

dialysis facilities must meet to receive Medicare coverage.

A key element of this regulation was the development of a new Web-based

data entry framework for dialysis facilities nationwide, which will

eventually provide substantially more detailed information for consumers

as part of Dialysis Facility Compare. CMS is also working to

implement a value-based purchasing program to pay for dialysis services,

which will reward facilities for providing high-quality, efficient, and

effective care.

The Dialysis Facility Compare Web site can be viewed at

www.medicare.gov/dialysis. Other provider compare Web sites are

available through www.medicare.gov

or directly at

www.medicare.gov/HHCompare

for information about home health agencies and nursing homes. For

information on hospitals, visit

www.hospitalcompare.hhs.gov. CMS also provides comparative resources

about Medicare Advantage

(www.medicare.gov/MPPF) and

Medicare prescription drug plans

(www.medicare.gov/MPDPF).