The Centers for Medicare & Medicaid Services has released the preliminary End-Stage Renal Disease Quality Incentive Program performance scores and penalties for dialysis clinics based on how they provided care to patients last year. Dialysis providers have until Aug. 15 to contest the results.
Over the last two years, 10% of dialysis clinics have received a scoring penalty from the ESRD QIP, which started in 2012. In the first year of the scoring system, 30% of dialysis clinics were penalized. The penalties now range from 0.5% up to 2% of a dialysis clinic’s composite rate payment based on how well they scored on the six clinical measures (make up 75% of the total performance score) and the four reporting measures (25% of the total performance score).
The clincial measures include Anemia Management, Vascular Access Type, and Kt/V Dialysis Adequacy (for in-center hemodialysis, peritoneal dialysis, and pediatric dialysis patients). The reporting measures include Dialysis Events (infections) via the Centers for Disease Control and Prevention’s National Healthcare Safety Network (NSHN); patient satisfaction via the In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems (ICH CAHPS) survey; mineral metabolism (now a clinical measure for performance year 2014), and Anemia Management.
The final scores will be released in November, and dialysis clinics will see the financial penalty, if assessed for their unit, in January 2015.
The review of the ESRD QIP scores coincides with CMS' new five-star rating system for dialysis clinics, based on data available on Dialysis Facility Compare. The agency released preliminary star ratings for each clinic on Tuesday via the www.dialysisreports.org website; providers have until Aug. 15 to object or challenge the star rating they receive. Read a summary of the program here, along with a guest blog expressing concerns about the program here.
CMS held a national provider call on Wednesday explaining the clinical and reporting measures used to assess performance in 2013 and how performance scores are calculated. The webinar will be made available for replay at a later date; slides from the program are available here.