#1) Luck !!!
“There is no patient input to the quality ratings being used by Medicare for dialysis centers. Quality ratings that at least partially consider patient satisfaction with their dialysis treatments might produce very different rankings,” Stephens said.
Editor's note: Is this outstanding medicine or what?
How many more millions of dollars and precious time must we waste trying to create a quality measurement system that uses biochemical markers that do not matter to patients — or uses measures that can be "manufactured" through manipulation and/or cheating?
The best example of excellence in dialysis care is a long-time employed ESRD patient. Unfortunately, CMS, U.S. nephrologists, and the large for-profit dialysis providers have ignored this outcome for decades. They have instead focused on biochemical markers, which has led to few improvements in the patients' quality of life or technological innovations over the last 40 years.
While DaVita and Fresenius have recently announced programs to support employment, there is little to them beyond "turfing" patients to government agencies that have no dialysis expertise.
It seems to be a new version of the intern's way to avoid addressing patients' needs. Remember "buff and turf" from The House of God?
What if Fresenius and DaVita employed dialysis patients and also paid their health insurance premiums? Extending the Medicare Secondary Payer (MSP) period for employed patients would then drive tremendous changes in this field of for-profit medicine.