In a previous related post, I promised I would post more about the Davita position on this when I got it. So, here it is and it makes some good points. “What’s Wrong With the 5-Star Rating System for the Renal Community” by Mahesh Krishnan, MD, MPH, MBA, FASN from NephrologyNews.com
Davita mostly takes issue with the “bell-curve” as a part of the rating system. If you’ve had experience with the bell-curve, you know it forces some of the items at each end of the curve and places most of the items in the middle. So if the best score on a test was 60 out of 100, that score would be on the far left of the curve and, if the worst score was 10 out of 100, it would be to the far right. The balance of the scores, 59 to 11 would be placed in the middle of the curve. A 60 in this case would be 5-stars and the 10 would be a 1-star, the others would be 2, 3, and 4-stars.
The problem lies in the CMS application of “grading on a curve” as a teacher might do with an exam. It allows the exam scores to fall within a bell-curve but it actually rewards mediocrity. If a facility does really well and scores 100 out of 100 but another scores 50 out of 100, those with scores between the two will be awarded 2, 3, and 4 stars where they might actually be awarded 1 and 5 stars if there was a rigid grading system like 90-100 is 5 stars, 70-89 is 4 stars, 50-69 is 3 stars, 30-59 is 2 stars, and anything below that is 1-star.
DPC (Dialysis Patient Citizens) has responded to the CMS proposal and puts it rather well, better than I can. So, please read their posting about it. Comment below if you have something to add to this.
DevonTexas © 2014
I am a person with ESRD (End Stage Renal Disease) which means my kidneys don't work. Forty or so years ago that would have been a death sentence but today there is Dialysis which means I could be hooked up to a machine that would clean my blood as the kidneys should. Three days a week, I went to a dialysis center and had too very large needles stuck in my arm to remove and replace my blood as it passed through a process where it was cleaned and the fluid was removed, a process taking a little over four hours each time.
In November 2017, I received a kidney transplant from a deceased donor. My life went into overdrive. With a "new" functioning kidney, I no longer had to go to a dialysis center and my days were not open to be lived rather than recovering from dialysis which meant dialyzing for three days and resting for 4 days a week. I work full-time and often 50 hours per week. It is something I never imagined. I highly recommend it! HeeHee
I want to advance knowledge about dialysis and transplant so that others can learn from my experience and mistakes. We shouldn't have to reinvent the wheel, eh? There is so much to be learned and experienced about our predicament. There are vast resources available to support us and enrich our lives but many patients don't know about them. There are also many issues that we have to deal with whether we want to or not. So I blog about them in www.DevonTexas.com
All comments are confidential until I approve them. If you don't want your comment public, let me know and I will respect that. So, feel free to leave a comment.
I also blog in LegacyTales in WordPress if you are interested in the ramblings of a Old Man. Give a peek and let me know what you think. https://legacytales.wordpress.com/
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Devon this is Kwame Cone, I did leave you my number and if can be of some assistance posting it will be fine. I will be posting some of my experiences concerning dialysis and mental health problems.