by Ida Sarsitis and Pamela Frederick HCFA, the Health Care Financing Administration, is the Federal agency that administers the Medicare and Medicaid programs, including the Medicare ESRD Program. This agency has been working to help kidney dialysis and transplant patients understand what Medicare benefits are available to them, what their disease is about, who to contact if they have a problem and what treatment choices are available to them. The following describes two recent activities that HCFA has completed. Dialysis Facility Compare Dialysis Facility Compare (DFC) is a new feature on the Medicare web site (www.medicare.gov), which is scheduled to be available in January. This feature will allow the public to obtain selected facility-specific information on most Medicare-approved dialysis facilities in the United States. This web site was developed as part of the Health Care Financing Administration's (HCFA) response to the Balanced Budget Act of 1997, which requires HCFA to measure and report the quality of dialysis services provided under the Medicare program. The information that will be displayed on this web site was recommended to HCFA by a workgroup of individuals from the renal community. To view the site, enter the URL: www.medicare.gov, click on Dialysis Facility Compare and follow the instructions. Dialysis facilities were given the opportunity to preview their data between Sept. 15 and Oct. 13, 2000. The purpose of the preview was to share the data with facilities and to get feedback regarding the accuracy and reliability of the data prior to public release of the information. Over 1,500 facilities submitted comments about their data. After reviewing the comments received during the preview period, HCFA made several decisions regarding what information to release. The information that will be available is shown below in Figure 1. This is the first set of dialysis facility-specific data that will be available to the public. HCFA plans to add more information as measures are identified and data collection mechanisms are put in place. Future information will include facility ownership type (profit or non-profit), whether the facility is owned or managed by a dialysis chain organization, the name of the chain organization, the types of dialysis services provided and the number of dialysis stations. Dialysis Facility Compare uses the most recent data available from systems containing facility characteristics and quality measures. The quality measures have been calculated using 1996-1998 claims data. In some cases, facilities may have made recent improvements to their processes resulting in better quality measures rates. If you have questions about these data, patients and families are encouraged to discuss them with their physician and/or staff at the facility. Dialysis Facility Compare also provides other useful information for the dialysis population such as, explanations of the data elements that are reported, contact phone numbers for the local ESRD Networks and State Survey Agencies and links to publications and other web sites. In addition, the web site includes information and resources that are of interest to ESRD patients. This includes information on: - Medicare coverage, eligibility, enrollment and costs
- Search and Compare tools for Medicare managed care plans, nursing homes and Medigap policies
- A nationwide calendar of local events and meetings
- An inventory of participating physicians
- Prescription drug assistance programs
- Publications printed in several languages
Individuals who do not have a personal computer with Internet capability may use any computer that has access to the Internet such as those computers used in local libraries, universities or by State Health Insurance Counselors. See the Local Contact Information on www.medicare.gov for specific telephone numbers. ESRD New Patient Package HCFA, through the ESRD Networks, began mailing uniform information in November 2000 to all newly diagnosed ESRD patients. These are patients for whom a HCFA-2728 Medical Evidence Form was completed by their physician, signed by the patient, and sent to the ESRD Network. This project was undertaken by HCFA in response to an Office of Inspector General's recommendation that all ESRD patients receive uniform information. In order to develop the contents of the package, HCFA through a contract with the ESRD Network Clearinghouse assembled a workgroup composed of representatives of six renal community organizations: American Association of Kidney Patients, American Nephrology Nurses Association, Life Options, National Renal Administrators Association, Renal Physicians Association, United Network for Organ Sharing and The Forum of ESRD Networks. Together, the group reviewed all the available information and developed recommendations for the contents of this package. The recommendation that was accepted by HCFA includes sending patients: The Medicare Coverage of Kidney Dialysis and Kidney Transplant Services booklet. This newly revised booklet explains how Medicare helps to pay for dialysis and kidney transplants. It also has phone numbers patients can call for assistance. Preparing for Emergencies: A Guide for Patients on Dialysis. This guide gives facts about what to do in case of an emergency. AAKP Patient Plan© -Phase 1. This booklet from the American Association of Kidney Patients provides easy to read information on kidney disease, treatment options and support. A letter of introduction from the appropriate ESRD Network. The ESRD Networks can assist patients in finding services, obtaining information and solving problems involving their care. This letter of introduction tells patients that the Networks work with patients to resolve concerns about their care that are not solved by talking to the staff at the facility and to help patients resolve concerns that they are uncomfortable discussing with the staff. A resource list of organizations that can help with their illness. The package contains a cover letter from HCFA's administrator, which tells patients that if they have a problem they may contact either, their ESRD Network or State Survey Agency. It also provides the phone numbers for these entities. It is HCFA's intention to evaluate the usefulness of this patient package to patients and determine if the package should be expanded or reduced. Figure 1. Dialysis Facility-Specific Information to be released on HCFA's medicare.gov web site. | | The following dialysis facility information will be released to the public on Jan. 19, 2001. | | Name of the dialysis facility; | | The physical address of the facility; | | The phone number of the facility; | | The date the facility was approved by Medicare to provide dialysis services; | | If the facility offers a dialysis shift that starts or continues after 5 p.m.; | | The percentage of patients who received adequate hemodialysis during 1998. (This is defined as a Urea Reduction Ratio (URR) of 65 percent or more. Note that this number will only include those patients on hemodialysis whose treatments were billed to Medicare.) | | The percentage of patients receiving Epoetin whose anemia was adequately managed during 1998. (This is defined as a hematocrit of 33 percent or more. Note that this number will only include those patients receiving Epoetin and whose treatments were billed to Medicare.) | | Patient survival categories for the period 1996-1998 reported as "as expected," "better than expected," or "worse than expected." | | After Jan. 19, you can view this information by using your internet browser and entering the URL: www.medicare.gov. Click on "Dialysis Facility Compare" and follow the instructions. |
Pamela Frederick is a technical advisor for the ESRD program in the Office of Clinical Standards and Quality, Health Care Financing Administration, Baltimore, Maryland. She currently directs HCFA's ESRD Clinical Performance Measures project and also works on HCFA's Dialysis Facility Compare web site project. Ida Sarsitis is a technical advisor for the ESRD program in the Office of Clinical Standards and Quality, Health Care Financing Administration, Baltimore, Maryland. She currently is in charge of implementing and evaluating the ESRD Network Contracts and for coordinating many of HCFA's ESRD projects. This article originally appeared in aakpRENALIFE, Vol. 16, No. 4, January 2001.
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