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New Information on Quality of Care at Dialysis Facilities

by Barbara Kram, Editor | November 25, 2008
Hemodialysis machine
The Centers for Medicare & Medicaid Services (CMS) has 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 anemia-a condition that affects many dialysis patients-and 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 measures-one 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).