New 5-Star Dialysis Facility Rating System To Debut

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‘Dialysis Facility Compare’ will tabulate publicly reported quality measures.
‘Dialysis Facility Compare’ will tabulate publicly reported quality measures.


But do patients really use these ratings systems? Many people say no. Dave Gifford, senior vice president for quality and regulatory affairs at the American Health Care Association, said he hasn't seen patients using Nursing Home Compare as expected initially.

“Consumers haven't really used it much,” he said. “They really look at location.”

Patients expect healthcare providers to meet certain standards and, unless there is a highly reported issue, they assume all providers offer about the same quality of services, said Kim Fox, vice president of the healthcare marketing firm Jarrard Phillips Cate & Hancock, Inc. in Brentwood, Tenn.

Most often, they choose providers by asking friends, family, and their primary care physician, Fox said. They look for places that are close to home, particularly with a frequent treatment like dialysis. They want a good personal experience and they will go where they have insurance coverage.

Consumers may not be wide users of the ratings, but Gifford said the nursing home industry has seen them used broadly in many different sectors. Managed care companies and Accountable Care Organizations are using them to determine network selection and provider partnerships. Banks use them to determine loan eligibility and insurance providers to negotiate fees.

Gifford said it is clear that the CMS ratings aren't always perfect, but overall, Nursing Home Compare has been good for the industry.

A number of centers have set goals by the standards and chains use them to hold their networks accountable for their staffing ratios and quality specifications used in the system. 

“Overall it has brought focus to the industry and gave targets where people can strive to improve care,” he said. “There are hundreds of things to work on at the centers but now we know where to focus to make changes.”

Crafting a response

Because providers know the rankings are coming and have an idea of where they will fall in line, Fox said the most important thing to do is take charge of your message. Each organization should understand how they will define and talk about quality. Find out how patients define quality and use that as a parameter for the message.

The star ratings can be confusing for patients, so she hesitates to place too much focus on it if a center gets a 4 or 5. If a group earns 1 or 2 stars, she recommends owning it. Don't fall into the trap of using the blame game, Fox said.

Saying the score is the fault of the system will sound defensive. Never put the focus on patients. Saying things like, “Our patients are sicker than everyone else's,” or, “We are low on a measurement because it's out of our control; the patients aren't following care instructions,” is a big no-no in her book.

Instead, say you are committed to providing quality care, and you are working on an actionable plan to increase your score. If you are already making strides or working in certain areas, talk about it. The current data on the site is from 2013. Some data are updated quarterly and some annually. That provides an opportunity to show that you have since made improvements in various areas.

“Recognize that people are going to see it,” she said. “Tell them how you approach quality and how you are improving it.” 

Jones said he plans to tell patients that the system should only be looked at along with other measures. He publishes QIP data on the bulletin board every fall for patients to see and plans to tell them it is a better barometer than CMS' system. 

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