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CMS selects new measures for Dialysis Facility Compare
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The Centers for Medicare & Medicaid Services (CMS) will add three new measures to Dialysis Facility Compare in October 2016. After review of public comments, CMS said it will begin publicly reporting dialysis clinic performance on the following measures on Dialysis Facility Compare:
- Bloodstream Infection in Hemodialysis Outpatients (NQF #1460)
- CAHPS (Consumer Assessment of Healthcare Providers) In-Center Hemodialysis Survey (National Quality Forum#0258)
- Pediatric Peritoneal Dialysis Adequacy: Achievement of Target Kt/V (NQF #2706)
Another proposed measure, high ultrafiltration rates (>13 ml/kg/hr) was not selected. CMS said that most commenters supported implementing NQF measure #2701 for tracking high ultrafiltration rates. "Currently only NQF measure #2700 (not NQF endorsed) is implementable as there is presently no national data source that collects the multiple data points required by measure #2701," CMS wrote. "However, CMS is currently working with the measure owner of an NQF-endorsed measure of ultrafiltration rate (NQF #2701) to develop a Change Request which would allow for the required data elements to be captured in the national CROWNWeb data system. Once required data elements are available CMS will re-evaluate the possibility of implementing a measure of Ultrafiltration Rate on DFC, but this measure will not be included in the October 2016 Refresh."
The measures will be applied to the Dialysis Facility Compare before being considered for the star ratings. CMS said that just because a measure has been approved for Dialysis Facility Compare doesn’t mean they will or should be included in the star rating.
Read also: About the Dialysis Facility Compare Star Rating program methodology
CMS currently applies a methodology based on 9 quality measures to create a star rating for dialysis facilities. More
CMS requested public comment on the proposed measures to increase transparency in the process and selection criteria and allow for increased input from the community on candidate measures. The agency said it would also welcome inclusion of externally developed measures on DFC.
The agency is creating a formalized review process for proposed dialysis facility five star measures. Like those used for the ESRD Quality Incentive Program, these measures will be vetted by the renal community and the National Quality Forum before implementation. CMS releases a “refresh” of the ratings in October of each year for the more than 5,000 dialysis facilities across the country.
CMS said commenters on the measures included the following: One dialysis patient, a health educator, American Kidney Fund, American Renal, DaVita, Dialysis Patients Citizens, Kidney Care Council, Kidney Care Partners, and Press Ganey.
DaVita presented four additional topic areas for future inclusion on Dialysis Facility Compare including influenza vaccination, peritonitis, CAHPS survey for patients dialyzing at home, and measures reporting on medication management. CMS said it would review the currently available Influenza Vaccinations and Home Version of the CAHPS measures and will explore the possibility of the inclusion of the measures in future Dialysis Facility Compare releases, and will evaluate whether to convene technical expert panels to assess future development of a peritonitis measure, and a medication management measure.