While dialysis providers scramble to fight a proposed 9.4% payment cut to the ESRD Program, the proposed changes for the End-Stage Renal Disease Program Quality Incentive Program have garnered little attention. In fact, many of the measures have been carried over from what dialysis facilities are using this year.

“We believe that, collectively, these measures will continue to promote improvement in dialysis care in the PY 2016 ESRD QIP and in future payment years,” CMS said in the proposed rule. There will be a planned focus on tracking outcomes in performance year 2014 for peritoneal dialysis and pediatric dialysis patients, as CMS begins to expand the scope of the ESRD QIP.

(CMS releases dialysis facility performance scores for ESRD QIP 2012)

Dialysis providers have until Aug. 30 to comment on the proposed measures, but CMS is planning an Medicare Learning Netowrk provider call on Aug. 14 to review the changes.

Here is a breakdown of clinical measures and reporting measures proposed for performance year 2014. Measures that are carried over or expanded are also noted.

Clinical measures (worth 75% of performance score)

Anemia management

(new) Patient informed consent for anemia treatment

Carried over measures: hemoglobin > 12 g/dL


Carried over measures/revised/expanded

A Kt/V measure for adult hemodialysis patients; for adult peritoneal dialysis patients; for pediatric hemodialysis patients

Vascular access care

Carried over measures: arterial venous (AV) fistula use, catheter use

Bone mineral metabolism management

(new) Measuring hypercalcemia

Patient safety

(new) National Healthcare Safety Network (NHSN) bloodstream infection in hemodialysis outpatients


Reporting Measures (worth 25% of performance score)

(new) Use of iron therapy in pediatric patients

(new) Gathering data on comorbidities

(new) Reporting phosphorus results

Carried over measures: anemia management, mineral metabolism, In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems (ICH CAHPS)

“At this time, we are not proposing to adopt measures that address care coordination, efficiency, population and community health, or cost of care," said CMS on future measures. "However, we are soliciting comments in this proposed rule on potential measures that would cover these areas."

CMS is holding the MLN provider call on August 14, from 3:00 pm – 4:30 pm EST. The agenda will include ESRD QIP legislative framework, proposed measures, standards, scoring methodology, and the payment reduction scale for PY 2016. CMS will also review the methods for reviewing and commenting on the proposed rule.

A link to the slide presentation will be posted at www.cms.gov/Outreach-and-Education/Outreach/NPC/National-Provider-Calls-and-Events-Items/2013-08-07-ESRD-NPC.html?DLPage=1&DLSort=0&DLSortDir=descending prior to the call.

To register for this MLN Connects National Provider Call, go to the CMS Upcoming National Provider Calls registration website at http://www.eventsvc.com/blhtechnologies/register/a461a437-841d-4da1-ab4e-a17a0fbdd987