Medicare 'Dialysis Facility Compare' Quality Measures for Provider Chains: Year 2000

November 25, 2002 - The U.S. Government's Dialysis Facility Compare web site feature provides 'quality of care' information on dialysis facilities that have been approved by Medicare. The owners of the dialysis facilities are also listed, which allows anyone who is curious to compare the major dialysis provider "chains".

60 percent (2440 of 4073) of the dialysis facilities in the current Dialysis Facility Compare (DFC) database are owned by five dialysis providers: Fresenius Medical Care (FMC), Gambro Healthcare, Dialysis Clinic, Inc. (DCI), DaVita, and Renal Care Group (RCG). DCI is the only non-profit organization of the group. There are 1255 dialysis facilities designated as NOT belonging to a "chain".

NOTE: Medicare also provides a Dialysis Facility Compare database for downloading. If you have the Microsoft Access Database application and would like to do your own statistical analyses, click here to download the Dialysis Compare database from the Medicare web site.

Before reviewing this data, be sure to view the Data Collection Details, the Glossary, adequacy data explanations, anemia data explanations, and survival data explanations from the DFC web site. According to Medicare, the source of the adequacy, anemia, and patient survival information is updated continuously and may undergo some level of review. However, not all items have been checked independently to verify accuracy.

Please keep in mind that this adequacy and anemia information is from 2000. The data is limited to the information for Medicare beneficiaries on dialysis and who are receiving hemodialysis. Therefore, depending on the number of Medicare beneficiaries at their facilities, the data for the entire patient population at the provider chain may actually vary from what is presented here. Contact the provider chain for their most current information, their non-Medicare patients adequacy information, as well as adequacy information for patients who are on peritoneal dialysis.

URR Data

At the current time, a URR of 65% or higher is considered adequate hemodialysis therapy. RenalWEB has a comprehensive listing of Internet resources on Hemodialysis Adequacy.

The national average for all dialysis facilities in the US for 2000 was 88 percent. This means that in an average US dialysis facility, 88% of the patients (Medicare beneficiaries on hemodialysis) have a URR of 65% or greater.

Using the Dialysis Facility Compare database that was downloaded from the Medicare web site on November 17, 2002, the following results were achieved by this method: The URR score for each facility (URRG65_F) was multiplied by the number of patients in that facility with URR data (PURR_F). This product is the "weighted facility score" for each facility. The weighted facility scores were then added together and divided by the total number of patients. The resulting quotient is the average facility URR score for the dialysis chain. Again, the national average for all US dialysis facilities was 88 percent.

Chains are listed in order of number of facilities. This information is based on 1999 data.

Fresenius Medical Care: 1033 facilities in the database, 876 facilities had URR data, URR data for 42,114 patients. Average facility URR score: 88.5 percent (up from the 1999 score of 86.0%)

Gambro Healthcare: 524 facilities in the database, 464 facilities had URR data, URR data for 20,901 patients. Average facility URR score: 89.9 percent (up from the 1999 score of 89.0%)

DaVita: 461 facilities in the database, 423 facilities had URR data, URR data for 20,130 patients. Average facility URR score: 91.6 percent (up from the 1999 score of 86.1%)

Renal Care Group: 248 facilities in the database, 199 facilities had URR data, URR data for 9,436 patients. Average facility URR score: 91.4 percent (up from the 1999 score of 89.9%)

Dialysis Clinic, Inc. (DCI): 174 facilities in the database, 139 facilities had URR data, URR data for 6,388 patients. Average facility URR score: 86.2 percent (up from the 1999 score of 84.5%)

Non-chain dialysis facilites: 1255 facilities in the database, 786 facilities had URR data, URR data for 37,150 patients. Average facility URR score: 86.3 percent

Anemia Management Data

Another 'quality measure' provided by the Dialysis Facility Compare feature is the percent of patients at a facility with a hematocrit (Hct) of 33 or greater (also known as anemia management).

At the current time, a Hct of 33% or higher is considered adequate anemia management. RenalWEB has a comprehensive listing of Internet resources on Anemia Management.

The national average for all dialysis facilities in the US for 2000 was 77 percent. This means that in an average US dialysis facility, 77% of the patients (Medicare beneficiaries on hemodialysis) have a Hct of 33% or greater.

Using the Dialysis Facility Compare database that was downloaded from the Medicare web site on November 17, 2002, the following results were achieved by this method: The Hct score for each facility (HCTG33_F) was multiplied by the number of patients in that facility with Hct data (HCTRD_F). This product is the "weighted facility score" for each facility. The weighted facility scores were then added together and divided by the total number of patients. The resulting quotient is the average facility Hct score for the dialysis chain. Again, the national average for all US dialysis facilities was 77 percent.

Chains are listed in order of number of facilities. This information is based on 1999 data.

Fresenius Medical Care: 1033 facilities in the database, 914 facilities had Hct data, Hct data for 53,153 patients. Average facility Hct score: 80.5 percent (up from the 1999 score of 75.6%)

Gambro Healthcare: 524 facilities in the database, 474 facilities had Hct data, Hct data for 27,411 patients. Average facility Hct score: 75.3 percent (down from the 1999 score of 76.8%)

DaVita: 461 facilities in the database, 436 facilities had Hct data, Hct data for 26,120 patients. Average facility Hct score: 83.5 percent (up from the 1999 score of 80.4%)

Renal Care Group: 248 facilities in the database, 211 facilities had Hct data, Hct data for 12,295 patients. Average facility Hct score: 82.7 percent (up from the 1999 score of 78.8%)

Dialysis Clinic, Inc. (DCI): 174 facilities in the database, 143 facilities had Hct data, Hct data for 8,007 patients. Average facility Hct score: 66.4 percent (down from the 1999 score of 71.7%)

Non-chain dialysis facilites: 1255 facilities in the database, 859 facilities had Hct data, Hct data for 49,486 patients. Average facility Hct score: 74.2 percent

Note: The number of patients with URR data and Hct data is greatly decreased in this year's Dialysis Facility Compare database. This is true for all the "chains" mentioned in this report.

As an example, the number of Fresenius Medical Care (FMC) dialysis facilities in the database with URR data increased from 775 in 1999 to 876 in 2000. However, the total number of FMC patients with reported URR data decreased from 67,249 in 1999 to 42,114 in 2000.

Here is the year 1999 report on the Dialysis Facility Compare data on the dialysis "chains".




[This message has been edited by Gary Peterson (edited 11-25-2002).]