By William E. Haley, MD, Renal Physicians Association, Alan S. Kliger, MD, Renal Physicians Association & Pamela Frederick, Centers for Medicare and Medicaid Services

Editor's Note: This article is an update of an article published in the January 2001 issue of aakpRENALIFE and the editorial response delivered by members of the Renal Physicians Association in the March 2001 issue of aakpRENALIFE.

In January, the Health Care Financing Administration (HCFA), now the Centers for Medicare & Medicaid Services (CMS), added a feature called "Dialysis Facility Compare" to its medicare.gov web site on the Internet, available at www.medicare.gov/Dialysis/Home.asp. A visitor to this site can find information about individual Medicare approved dialysis facilities, including facility characteristics and quality measures. This site was described in the January 2001 issue of aakpRENALIFE.

The Renal Physicians Association's (RPA) March 2001 editorial in response to Dialysis Facility Compare stated that the site included information on staff composition, staff-to-patient ratios and rates of referral for kidney transplantation. Although these facility characteristics were initially recommended to CMS by the multi-disciplinary Consumer Workgroup, CMS made the decision to not report this information because of concerns about the accuracy of the data source being considered for this information. The web site contains dialysis facility ownership information, types of services offered, other facility characteristics and patient outcomes including dose of dialysis, results of anemia treatment and patient survival. Visitors will also find specific language that encourages individuals to talk with their doctor about the information on the site. The site also encourages patients to visit dialysis facilities they are interested in and to contact any dialysis facility to ask questions about the facility's most recent quality information.

The RPA supports Dialysis Facility Compare as an important first step to providing meaningful information to the public about the quality of care delivered in individual dialysis facilities. The RPA and CMS agree that there is a critical need to disseminate accurate information to the community about dialysis facility characteristics and outcomes. CMS, RPA, other renal organizations and dialysis patients will continue to work together to help provide public information that is of the greatest utility and accuracy.

The whole dialysis care community, including providers, regulators and patients agree on several fundamental points:

• Meaningful information on dialysis facility characteristics and outcomes should be published.
• This information should be easily available to all patients and their families.
• Published information should be accurate, timely and comprehensible to healthcare consumers.
• Patients and their families should be encouraged to discuss their dialysis facility's outcomes with their care teams and to ask how their own individual results measure against published quality guidelines.
• Patients and their families should ask how they might participate in their dialysis facility's quality guidelines.

We must continue to work together as a community to define what patients and their families want to know and need to know about their care, define accurate sources for this information, collect current results and then make it widely available. We welcome any comments or suggestions about what information is important to you. You can contact Drs. Haley or Kliger through the RPA office at rpa@renalmd.org. Comments can be submitted to CMS by clicking on the word "comments" at the bottom of the Dialysis Facility Compare web site page and following the instructions.

Pamela Frederick is a technical advisor for the ESRD Program in the Center for Beneficiary Choices, Centers for Medicare & Medicaid Services, formerly the Health Care Financing Administration, Baltimore, Maryland. She currently directs CMS's ESRD Clinical Performance Measures project and works on CMS's Dialysis Facility Compare web site project.

William E. Haley, MD, serves as Senior Associate Consultant, Division of Hypertension & Nephrology at the Mayo Clinic Jacksonville in Jacksonville, Florida and as Assistant Professor of Medicine at the Mayo Medical School.

Alan Kliger, MD, is a Clinical Professor of Medicine at Yale University School of Medicine and is Medical Director of New Haven CAPD in Connecticut.

This article originally appeared in Special Edition 2001 aakpRENALIFE, Vol. 17, No. 2.

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