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Medicare Agency Under Fire For “Star” Ratings of Health Care Providers

2024-03-29T02:08:04+00:00September 3rd, 2014|Categories: 5-Star Ratings, Article, Comment Letter, Quality Incentive Program|

Can Dialysis Facilities Be Rated Like Movies and Restaurants? Earlier this year, the Center for Medicare and Medicaid Services (CMS) announced plans to expand its movie critic-style “star” rating system, currently in place for nursing homes and Medicare HMOs, to include dialysis facilities and other health care providers. The controversy began earlier this summer when CMS disclosed the system it had devised to assign star ratings for dialysis facilities. DPC was among the first to speak out and express concern, emphasizing four items in particular: Stars were to be assigned on a “bell curve” grading system, in which thirty percent of [...]

DPC Comments on 2015 Prospective Payment System and QIP

2024-03-29T02:08:04+00:00August 28th, 2014|Categories: Comment Letter, Dialysis Funding, Quality Incentive Program|

Hon. Marilyn Tavenner, Administrator Centers for Medicare and Medicaid Services Department of Health and Human Services Hubert H. Humphrey Building 200 Independence Avenue, SW Washington, D.C. 20201 Re: CMS-1614-P: End-Stage Renal Disease Prospective Payment System, Quality Incentive Program, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Dear Administrator Tavenner: Dialysis Patient Citizens (DPC) appreciates the opportunity to provide the Centers for Medicare and Medicaid Services (CMS) with comments on the proposed payment rule for the Medicare End Stage Renal Disease (ESRD) program. As America’s largest patient-led organization representing dialysis patients, DPC’s membership consists of more than 26,000 dialysis and pre-dialysis [...]

Kidney Patients Join Industry In Opposing CMS’ Dialysis Star Rating System

2024-03-29T02:08:05+00:00August 8th, 2014|Categories: 5-Star Ratings, Press|

Kidney patients have joined the fight against the Medicare star-rating program for dialysis facilities, and they’re making the same arguments as industry. Patient advocates say that the bell curve nature of the program will confuse patients, especially those in poor areas; the program is inconsistent with the existing dialysis Quality Incentive Program; and CMS should have sought feedback from patients and providers before forcing the program on them

New Medicare Rule for Dialysis Facilities Brings Changes to “Pay for Performance” Formula

2024-03-29T02:08:05+00:00July 1st, 2014|Categories: Get Involved, Quality Incentive Program, Take Action|

Last week, the Centers for Medicare and Medicaid Services (CMS) released its Proposed Rule specifying how dialysis facilities will be paid in 2015 and beyond. Most of the proposed changes relate to the Quality Improvement Program for dialysis. The Quality Improvement Program (QIP) sets performance standards for each clinic and penalizes clinics that do not meet or make progress toward the standards by cutting their payments by up to two percent. The purpose is to incentivize providers to do a better job by tying their pay to performance. This year’s rule proposes several changes including new measures related to: patient [...]

Quality Incentive Program in July

2024-03-29T02:08:05+00:00June 30th, 2014|Categories: Article, Quality Incentive Program|

The Center for Medicare & Medicaid Services (CMS) has an ongoing quality incentive program, the first of its kind, for End Stage Renal Disease (ESRD) care. The quality incentive program, or QIP, is intended to improve the care provided to ESRD patients by paying dialysis facilities based on the quality of care they deliver. If a facility fails to meet certain performance standards, they may receive a lower performance score, which results in lower payments to the facility. Each July, CMS releases a proposed rule with changes they suggest for the following year’s ESRD QIP. This rule is published online [...]

Dialysis Reimbursements Stabilized by Protecting Access to Medicare Act

2024-03-29T02:08:06+00:00April 2nd, 2014|Categories: Article, Dialysis Funding, Immunosuppressive Drug Coverage|

This week President Obama signed the Protecting Access to Medicare Act, which contained some provisions favorable to dialysis patients. The primary purpose of the legislation was to stabilize Medicare payments to physicians, but Congress also used the opportunity to stabilize reimbursements to dialysis facilities. A large cut that had been scheduled to take effect in 2016 has been replaced by smaller, fixed-amount cuts that afford providers more certainty about revenues in coming years. This new payment formula will encourage providers to renew expiring leases on dialysis facilities and continue to invest in improved kidney care infrastructure. Another provision further delays addition [...]

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