May 2, 2001 - Earlier this year, Medicare rolled out the Dialysis Facility Compare feature on its website. This feature provides detailed information about US dialysis facilities that were approved by Medicare as of January 1, 2000. This information consists of facility demographic data and three "quality of care" measurements, which allows the website visitors to compare patient outcomes at different dialysis facilities.

Data for the Dialysis Facility Compare (DFC) feature comes from many sources. Many omissions and errors were found the initial January release of the DFC database, resulting in a February update that had over half of the initial data fields removed.

An update of the DFC quality measures data is planned for this July. In order to avoid as many errors as possible, Medicare is providing a mechanism for dialysis facilities to review the data before it is posted to the DFC web site. The Health Care Financing Administration (HCFA) has contracted with PRO-West to provide a website for this function. The website provides dialysis facilities an opportunity to submit comments on their updated quality measures.

HCFA has instructed the ESRD Networks to distribute the 2001 Unit Specific Reports (USR) to all facilities by April 30, 2001. If the facility believes any of its quality measures are inaccurate, it may submit an explanation of why it believes it is incorrect through the PRO-West website. This will accessible from May 1 to May 31, 2001. After May 31, no comments will be accepted.

If the facility finds errors in any of the descriptive information (address, # of stations, etc.) that is included in the DFC, it should contact the appropriate ESRD Network office.

February 15, 2001 - "Dialysis Facility Compare" is a feature on the Medicare web site that gives detailed information about dialysis facilities that were approved by Medicare as of January 1, 2000. This information presently includes two quality outcome measures: dialysis adequacy and patient survival information.

There are twelve facilities that are in the top 10% for dialysis adequacy (URR) and have a better than expected patient survival rate. According to these two 'quality of care' measurements and the available data from 1998, the best cared-for dialysis patients in the United States can be found at these facilities:

GAMBRO HEALTHCARE - GREENE COUNTY DX, Eutaw, AL
GAMBRO HEALTHCARE (PEACHTREE), Atlanta, GA
TRI-STATE DIALYSIS - DUBUQUE, Dubuque, IA
RENAL CARE GROUP - COLUMBUS, Columbus, MS
FMC ESPANOLA DIALYSIS, Espanola, NM
RMCH - ZUNI, Zuni, NM
FMC WEST ALBUQUERQUE DIALYSIS CTR, Albuquerque, NM
GREENVILLE DIALYSIS CENTER, INC., Greenville, SC
METROPLEX KIDNEY DISEASE CTR, Killeen, TX
NNA - SAN MARCOS, San Marcos, TX
FLETCHER ALLEN HEALTH CARE: SATELLITE, Barre, VT
BMA - BLUEFIELD, Bluefield, WV

See the listings below for facilities receiving the highest and lowest ratings in the Dialysis Facility Compare database that was released on February 14, 2001.

February 14, 2001 - Medicare's Dialysis Facility Compare web site once again is providing a database of comparative information about dialysis facilities that can be downloaded.

The amount of data about each dialysis facility has been drastically reduced in this latest release. The first release of the Dialysis Facility Compare database in January had 80 fields of information for each facility, while the new database has only 29 fields.

The anemia management data is still being investigated. No date has been given when it will be reinserted.

Data that was eliminated in this release of the database include:

- facility chain ownership (will be reinserted in April)
- services provided (PD, HD) (will be reinserted in April)
- staffing ratios

Dialysis Facility Compare Reports - Feb 2001

Before reviewing these reports, be sure to view the Data Collection Details. 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.

The Urea Reduction Ratio (URR) data is from 1998 and the Patient Survival data is for the period from 1996-1998. With that in mind, here are 'quality of care' reports on US dialysis facilities prepared from the Dialysis Facility Compare database downloaded on 2/14/2001:

Dialysis Adequacy - The percent of patients at a facility with a Urea Reduction Ratio (URR) of 65 or greater: (Adequacy background info)

Top 10 Percent of Facilities (250 out of 2465 reporting)

Bottom 5 Percent of Facilities (122 out of 2465 reporting)

1016 of 3481 facilities did not have URR data.

Patient Survival Information - Actual Compared to Expected for 1996-1998. Click here to view the survival categories explanation and examples.

Higher Than Expected Patient Survival (48 facilities)

Lower Than Expected Patient Survival (62 facilities)

Expected Patient Survival (2617 facilities)

754 of 3481 facilities had no survival data.

[This message has been edited by Gary Peterson (edited 05-02-2001).]