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| 1 Peer Report: Dialysis Care & Outcomes in the U.S., 2014 | 5-STAR QUALITY RATING SYSTEM Peer Report: Dialysis Care & Outcomes in the U.S., 2014 5-Star Quality Rating System

| 1| 1Peer Report: Dialysis Care & Outcomes in the U.S., 2014 | 5-STAR QUALITY RATING SYSTEM Peer Report: Dialysis Care & Outcomes in the U.S., 2014 5-Star

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Page 1: | 1| 1Peer Report: Dialysis Care & Outcomes in the U.S., 2014 | 5-STAR QUALITY RATING SYSTEM Peer Report: Dialysis Care & Outcomes in the U.S., 2014 5-Star

| 1Peer Report: Dialysis Care & Outcomes in the U.S., 2014 | 5-STAR QUALITY RATING SYSTEM

Peer Report: Dialysis Care & Outcomes in the U.S., 2014

5-Star Quality Rating System

Page 2: | 1| 1Peer Report: Dialysis Care & Outcomes in the U.S., 2014 | 5-STAR QUALITY RATING SYSTEM Peer Report: Dialysis Care & Outcomes in the U.S., 2014 5-Star

| 2Peer Report: Dialysis Care & Outcomes in the U.S., 2014 | 5-STAR QUALITY RATING SYSTEM

CMS methodology

Page 3: | 1| 1Peer Report: Dialysis Care & Outcomes in the U.S., 2014 | 5-STAR QUALITY RATING SYSTEM Peer Report: Dialysis Care & Outcomes in the U.S., 2014 5-Star

| 3Peer Report: Dialysis Care & Outcomes in the U.S., 2014 | 5-STAR QUALITY RATING SYSTEM

Assignment of star ratings, on the basis of scores from CMS methodology

Page 4: | 1| 1Peer Report: Dialysis Care & Outcomes in the U.S., 2014 | 5-STAR QUALITY RATING SYSTEM Peer Report: Dialysis Care & Outcomes in the U.S., 2014 5-Star

| 4Peer Report: Dialysis Care & Outcomes in the U.S., 2014 | 5-STAR QUALITY RATING SYSTEM

Comparison of rating from CMS methodology vs. rating based exclusively on standardized mortality ratio (SMR) & standardized hospitalization ratio (SHR) SMR & SHR weighted equally

Page 5: | 1| 1Peer Report: Dialysis Care & Outcomes in the U.S., 2014 | 5-STAR QUALITY RATING SYSTEM Peer Report: Dialysis Care & Outcomes in the U.S., 2014 5-Star

| 5Peer Report: Dialysis Care & Outcomes in the U.S., 2014 | 5-STAR QUALITY RATING SYSTEM

Comparison of rating from CMS methodology vs. rating based exclusively on standardized mortality ratio (SMR) & standardized hospitalization ratio (SHR) SMR & SHR weighted equally

Page 6: | 1| 1Peer Report: Dialysis Care & Outcomes in the U.S., 2014 | 5-STAR QUALITY RATING SYSTEM Peer Report: Dialysis Care & Outcomes in the U.S., 2014 5-Star

| 6Peer Report: Dialysis Care & Outcomes in the U.S., 2014 | 5-STAR QUALITY RATING SYSTEM

Comparison of rating from CMS methodology vs. rating with 50 percent weight ascribed to standardized mortality ratio (SMR) & standardized hospitalization ratio (SHR) In CMS methodology, only 22 percent of weight is ascribed to SMR & SHR

Page 7: | 1| 1Peer Report: Dialysis Care & Outcomes in the U.S., 2014 | 5-STAR QUALITY RATING SYSTEM Peer Report: Dialysis Care & Outcomes in the U.S., 2014 5-Star

| 7Peer Report: Dialysis Care & Outcomes in the U.S., 2014 | 5-STAR QUALITY RATING SYSTEM

Comparison of rating from CMS methodology vs. rating with 50 percent weight ascribed to standardized mortality ratio (SMR) & standardized hospitalization ratio (SHR) In CMS methodology, only 22 percent of weight is ascribed to SMR & SHR

Page 8: | 1| 1Peer Report: Dialysis Care & Outcomes in the U.S., 2014 | 5-STAR QUALITY RATING SYSTEM Peer Report: Dialysis Care & Outcomes in the U.S., 2014 5-Star

| 8Peer Report: Dialysis Care & Outcomes in the U.S., 2014 | 5-STAR QUALITY RATING SYSTEM

Comparison of rating from CMS methodology vs. rating based exclusively on Kt/V & hypercalcemia metrics

Page 9: | 1| 1Peer Report: Dialysis Care & Outcomes in the U.S., 2014 | 5-STAR QUALITY RATING SYSTEM Peer Report: Dialysis Care & Outcomes in the U.S., 2014 5-Star

| 9Peer Report: Dialysis Care & Outcomes in the U.S., 2014 | 5-STAR QUALITY RATING SYSTEM

Comparison of rating from CMS methodology vs. rating based exclusively on Kt/V & hypercalcemia metrics

Page 10: | 1| 1Peer Report: Dialysis Care & Outcomes in the U.S., 2014 | 5-STAR QUALITY RATING SYSTEM Peer Report: Dialysis Care & Outcomes in the U.S., 2014 5-Star

| 10Peer Report: Dialysis Care & Outcomes in the U.S., 2014 | 5-STAR QUALITY RATING SYSTEM

Comparison of rating from CMS methodology vs. rating based exclusively on fistula & catheter metrics

Page 11: | 1| 1Peer Report: Dialysis Care & Outcomes in the U.S., 2014 | 5-STAR QUALITY RATING SYSTEM Peer Report: Dialysis Care & Outcomes in the U.S., 2014 5-Star

| 11Peer Report: Dialysis Care & Outcomes in the U.S., 2014 | 5-STAR QUALITY RATING SYSTEM

Comparison of rating from CMS methodology vs. rating based exclusively on fistula & catheter metrics

Page 12: | 1| 1Peer Report: Dialysis Care & Outcomes in the U.S., 2014 | 5-STAR QUALITY RATING SYSTEM Peer Report: Dialysis Care & Outcomes in the U.S., 2014 5-Star

| 12Peer Report: Dialysis Care & Outcomes in the U.S., 2014 | 5-STAR QUALITY RATING SYSTEM

Comparison of rating from CMS methodology vs. rating that reflects uncertainty in estimates of standardized outcome ratios

Page 13: | 1| 1Peer Report: Dialysis Care & Outcomes in the U.S., 2014 | 5-STAR QUALITY RATING SYSTEM Peer Report: Dialysis Care & Outcomes in the U.S., 2014 5-Star

| 13Peer Report: Dialysis Care & Outcomes in the U.S., 2014 | 5-STAR QUALITY RATING SYSTEM

Comparison of rating based exclusively on Kt/V & hypercalcemia metrics vs. rating based exclusively on fistula & catheter metrics