Research from University of Michigan Yields New Findings on Managed Care (The Impact of Transplant Waitlisting Measures on Dialysis Facilities’ Star Ratings): Managed Care

2025 DEC 09 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- New research on Managed Care is the subject of a report. According to news reporting out of Ann Arbor, Michigan, by NewsRx editors, research stated, “To evaluate how adding kidney transplantation waitlisting measures-the Standardized First Kidney Transplant Waitlist Ratio for Incident Dialysis Patients (SWR) and Percentage of Prevalent Patients Waitlisted (PPPW)-affects Dialysis Facility Care Compare Star Ratings. In this observational, cross-sectional study, we calculated the difference between facilities’ published (with waitlisting measures) and counterfactual (without waitlisting measures) Star Ratings.”

Financial support for this research came from Centers for Medicare and Medicaid Services.

Our news journalists obtained a quote from the research from the University of Michigan, “We used multinomial regression to examine associations between Star Rating changes after waitlisting measure inclusion and facility characteristics and calculated corresponding average risk differences. We used comprehensive clinical and administrative data from the Centers for Medicare/Medicaid Services from 2021 to investigate the impact of waitlisting measure addition on Star Ratings. Facility characteristics included demographic and patient mix, area deprivation index (ADI), dialysis organization affiliation, and urbanicity. 36.5% of facilities’ ratings changed after waitlisting measures were added. Facility characteristics associated with a higher average risk of Star increase included location in low-ADI (0.091; 95% CI: 0.072, 0.109) or urban areas (0.061; 95% CI: 0.034, 0.087), independent/small dialysis organization affiliation (0.062; 95% CI: 0.041, 0.083), and having more PD patients (0.115; 95% CI: 0.093, 0.138). Characteristics associated with a higher average risk of Star decrease included high-ADI (0.075; 95% CI: 0.054, 0.095) or rural (0.056; 95% CI: 0.028, 0.083) location, large dialysis organization affiliation (0.058; 95% CI: 0.039, 0.078), having more patients with dual Medicare/Medicaid eligibility (0.052; 95% CI: 0.032, 0.071), and having fewer peritoneal dialysis patients (0.100; 95% CI: 0.081, 0.120). Including waitlisting measures significantly impacts the Star Ratings and captures a new dimension of care quality. Worse socioeconomic status-related facility characteristics were strongly associated with worse Star Rating outcomes.”

According to the news editors, the research concluded: “These findings can inform future discussions about risk adjustment among the developers of the SWR and PPPW measures.”

This research has been peer-reviewed.

For more information on this research see: The Impact of Transplant Waitlisting Measures on Dialysis Facilities’ Star Ratings. Health Services Research, 2025. Health Services Research can be contacted at: Wiley, 111 River St, Hoboken 07030-5774, NJ, USA. (Wiley-Blackwell - http://www.wiley.com/; Health Services Research - http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1475-6773)

Our news journalists report that additional information may be obtained by contacting Stephen Salerno, Kidney Epidemiology and Cost Center, University of Michigan, Ann Arbor, Michigan, United States. Additional authors for this research include Eileen Yang, Claudia Dahlerus, Richard A. Hirth, Tao Xu, Ashley Eckard, Wilfred Agbenyikey, Golden M. Horton, Stephanie Clark, Joseph M. Messana and Yi Li.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1111/1475-6773.70071. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

Publisher contact information for the journal Health Services Research is: Wiley, 111 River St, Hoboken 07030-5774, NJ, USA.

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