Observable Flaws in CMS’s Dialysis Star-Rating System and a Proposed Alternative
Alex Brill | Bloomberg BNA
In January 2015, CMS launched a star-rating system for U.S. dialysis facilities. This article analyzes nearly 6,000 U.S. dialysis facilities and explores trends and variations in star-rating scores based on facility characteristics and local demographic factors. Statistical tests show variation across states and by demographic factors.
For example, facilities serving communities with more black residents or communities with lower median incomes tend to score lower. Regression analysis indicates that communities with higher incomes have facilities that perform better overall and in particular better on certain underlying metrics.
This finding suggests that CMS’s program, which seeks to measure facility quality, not patient characteristics, needs further revision.