Medicare 'Dialysis Facility Compare' Quality Measures for Provider Chains

August 9, 2001 - The Dialysis Facility Compare 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".

59 percent (2223 of 3761) 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 (previously known as Total Renal Care), and Renal Care Group (RCG). DCI is the only non-profit organization of the group.

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 and anemia data explanations from the DFC web site. According to Medicare, the source of the adequacy and anemia 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 1999. 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 and 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 1999 was 86%. This means that in an average US dialysis facility, 86% 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 August 9, 2001, 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 86%.

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

Fresenius Medical Care: 928 facilities in the database, 775 facilities had URR data, URR data for 67,249 patients. Average facility URR score: 86.0 percent (up from the 1998 score of 84.3%)

Gambro Healthcare: 489 facilities in the database, 431 facilities had URR data, URR data for 38,586 patients. Average facility URR score: 89.0 percent (up from the 1998 score of 87.1%)

DaVita (previously known as Total Renal Care): 451 facilities in the database, 391 facilities had URR data, URR data for 33,859 patients. Average facility URR score: 86.1 percent (up from the 1998 score of 78.4%)

Renal Care Group: 203 facilities in the database, 177 facilities had URR data, URR data for 16,085 patients. Average facility URR score: 89.9 percent (up from the 1998 score of 88.8%)

Dialysis Clinic, Inc. (DCI): 152 facilities in the database, 126 facilities had URR data, URR data for 10,826 patients. Average facility URR score: 84.5 percent (up from the 1998 score of 80.2%)

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 1999 was 73%. This means that in an average US dialysis facility, 73% 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 August 9, 2001, 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 73%.

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

Fresenius Medical Care: 928 facilities in the database, 815 facilities had Hct data, Hct data for 62,233 patients. Average facility Hct score: 75.6 percent

Gambro Healthcare: 489 facilities in the database, 447 facilities had Hct data, Hct data for 34,848 patients. Average facility Hct score: 76.8 percent

DaVita (previously known as Total Renal Care): 451 facilities in the database, 401 facilities had Hct data, Hct data for 32,700 patients. Average facility Hct score: 80.4 percent

Renal Care Group: 203 facilities in the database, 184 facilities had Hct data, Hct data for 14,671 patients. Average facility Hct score: 78.8 percent

Dialysis Clinic, Inc. (DCI): 152 facilities in the database, 130 facilities had Hct data, Hct data for 9,463 patients. Average facility Hct score: 71.7 percent

[This message has been edited by Gary Peterson (edited 03-08-2002).]