Medicare Pulls Anemia Management Data from 'Dialysis Facility Compare' Feature

Some of the major dialysis providers (chains) have contacted RenalWEB to point out that the content of the first release of the Dialysis Facility Compare database was less than complete.

January 22,2001 - On January 19, 2001, Medicare put the Dialysis Facility Compare feature on its web site.

The Dialysis Facility Compare feature provides 'quality of care' information on dialysis facilities that were approved by Medicare as of January 1, 2000. The owners of the dialysis facilities are also listed, which allows anyone who is curious to compare the major dialysis provider "chains".

Approximately half of the dialysis facilities in the US are owned by five dialysis providers: Fresenius Medical Care (FMC), Gambro Healthcare, Dialysis Clinics Inc. (DCI), DaVita (previously known as Total Renal Care), and Renal Care Group (RCG).

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.

RenalWEB has discovered that the "download database" has several dialysis facilities that are not included in the Medicare on-line Dialysis Compare database. The information that follows have been prepared with the Dialysis Facility Compare database that was downloaded from the Medicare web site on January 20, 2001.

Before reviewing this information, 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.

RenalWEB has reviewed the Dialysis Facility Compare database and has found, as a general rule, the Urea Reduction Ratio (URR) and Hematocrit data to be from 1998 and the Patient Survival data to cover the period from 1996-1998.

Dialysis Adequacy Information for Dialysis Chains

One of the quality outcome measurements of the Dialysis Facility Compare feature is the percent of patients at a facility with a Urea Reduction Ratio (URR) of 65 or greater (known as adequacy of hemodialysis).

At the current time, a URR of 65% or higher is considered adequate hemodialysis therapy. Click here for an explanation of URR and dialysis adequacy from the NIDDK web site. RenalWEB has a comprehensive listing of Internet resources on Hemodialysis Adequacy.

The national average for all dialysis facilities in the US for 1998 was 82.6%. This means that in an average US dialysis facility, 82.6% of the patients have a URR of 65% or greater.

Using the Dialysis Facility Compare database that was downloaded from the Medicare web site on January 20, 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 82.6%.

Chains are listed in order of number of facilities.

Fresenius Medical Care: 709 facilities in the database, 624 facilities had URR data, URR data for 33,098 patients. Average facility URR score: 84.3%

Gambro Healthcare: 460 facilities in the database, 370 facilities had URR data, URR data for 16,554 patients. Average facility URR score: 87.1%

Total Renal Care (renamed DaVita in 2000): 407 facilities in the database, 326 facilities had URR data, URR data for 15,016 patients. Average facility URR score: 78.4%

Dialysis Clinic Inc. (DCI): 142 facilities in the database, 110 facilities had URR data, URR data for 5,579 patients. Average facility URR score: 80.2%

Renal Care Group: 80 facilities in the database, 61 facilities had URR data, URR data for 3079 patients. Average facility URR score: 88.8%