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CMS Proposes Payment Updates for ESRD and New Policies for Quality Incentive Program (QIP)

2024-03-29T01:50:29+00:00July 4th, 2016|Categories: Article, Quality Incentive Program|

Each year, the Centers for Medicare & Medicaid Services (CMS) issue proposed rules to update payment rates under the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for renal dialysis services for the following year.  On June 24, 2016, CMS proposed updates to the PPS as well as new quality measures for 2017. Notably, CMS proposed an increase to the base rate paid to dialysis facilities of $0.65 in addition to proposing increasing the home and self-dialysis training payment. In regards to quality measures, CMS proposes the inclusion of a new “Safety Measure Domain” category for 2019, which would provide data on dialysis-events including [...]

CMS Updates Policies and Payment Rates for End-Stage Renal Disease Facilities for 2016

2024-03-29T01:50:31+00:00November 9th, 2015|Categories: Article, Quality Incentive Program|

On October 30, the Centers for Medicare & Medicaid Services (CMS) issued a final rule to update payment policies and rates under the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for renal dialysis services furnished after January 1, 2016. The agency said the “ESRD final rule is one of several rules for calendar year 2016 that reflect a broader Administration-wide strategy to provide quality care at lower cost by improving ways to deliver care, pay providers, and use information.” This final rule also includes changes to the ESRD Quality Incentive Program (QIP) for payment years 2017-2019. Under the ESRD [...]

DPC Comments on 2016 Prospective Payment System and QIP

2024-03-29T01:50:32+00:00September 16th, 2015|Categories: Comment Letter, Quality Incentive Program|

DPC recently sent a comment letter responding to the proposed payment rule for CMS’s Medicare End Stage Renal Disease program. Using responses from our 2015 Patient Survey, our suggestions focus on how CMS can improve on the key issues of payment and quality for patients. On the payment side, we urge CMS to revise its patient-level payment system by focusing on individuals’ experiences, instead of drawing conclusions based off of large amounts of data. Better support of rural facilities and home dialysis is also important, providing more access and opportunity for treatment. On the quality front, we suggest changes be [...]

What are Dialysis Patients’ Priorities for Quality Information? Insights from DPC Patient Survey

2024-03-29T01:50:33+00:00March 11th, 2015|Categories: 5-Star Ratings, Article, Quality Incentive Program|

After the Centers for Medicare and Medicaid Services (CMS) announced its plans to release the Dialysis Facility Compare star rating system, DPC began to discuss with its membership what would make such a rating system successful. The two areas that DPC’s Board Members, Patient Ambassadors and membership all rated highest were 1) staff respect/listening and 2) patient education. Staff Respect/Listening: This topic compresses two questions from the annual Consumer Assessment of Healthcare Providers and Systems (CAHPS) questionnaire that Medicare requires dialysis patients to complete. It was even more apparent during our focus group discussions of our survey responses how upset [...]

DPC Elevates Patient Priorities with Medicare Regarding Dialysis Facility Compare Star Ratings

2024-03-29T01:50:34+00:00February 18th, 2015|Categories: 5-Star Ratings, Comment Letter, Quality Incentive Program|

Elena Balovlenkov, R.N. Technical Lead for Dialysis Facility Compare Centers for Medicare & Medicaid Services 7500 Security Boulevard Mail Stop S3-02-01 Baltimore, MD 21224 Dear Elena: To meet your timeline for raising issues to be brought before the DFC Star Rating TEP, DPC recently conducted a survey of our active patient volunteers asking them to identify priority items for quality measures to be included in both DFC star ratings and the QIP. Per the advice of the Kidney Care Quality Alliance (KCQA) consultant on quality measures, we developed a lengthy list of subjects for measures, and asked patients to choose [...]

Department of Health & Human Services Announces Pay-for-Performance Goals

2024-03-29T01:50:34+00:00February 4th, 2015|Categories: Article, Quality Incentive Program|

The US Department of Health & Human Services (HHS) recently announced goals for shifting the traditional fee-for-service Medicare payment model to a pay-for-performance model. In a pay-for-performance model, payment is based on the quality rather than quantity of care provided. One HHS goal is to tie 30% of fee-for-service Medicare payments to quality through alternative payment models like Accountable Care Organizations or bundled payments by the end of 2016, and 50% by the end of 2018. The dialysis community has a unique history in this area. Dialysis providers did not used to receive an annual update in their Medicare payments, but [...]

New Dialysis Quality Rules May Bring Small but Noticeable Changes to Your Care

2024-03-29T01:50:35+00:00November 13th, 2014|Categories: Article, Quality Incentive Program|

The Centers for Medicare and Medicaid Services (CMS) recently finalized the payment rule for the Medicare End Stage Renal Disease (ESRD) program for 2015. Payment rates will stay the same next year. However, changes to the Quality Improvement Program (QIP) system of "pay for performance" are intended to prioritize new aspects of care for ESRD patients; providers are graded on each element of the "QIP" and receive payment reductions if they don't meet Medicare's standard. This means that providers are expected to add emphasis to these new areas in their interactions with patients. Here are some of the new areas being [...]

DPC Submits Comments on this Year’s Medicare ESRD Payment Rule

2024-03-29T02:08:04+00:00September 4th, 2014|Categories: Article, Dialysis Funding, Quality Incentive Program|

In late August, DPC submitted comments to the Center for Medicare and Medicaid Services (CMS) on its payment-setting rule for dialysis facilities in 2015. The rule keeps next year’s payments for dialysis level with this year’s, following a mandate from Congress, but makes some changes to the ESRD Quality Incentive Program (“QIP”) that reduces payments to the lowest-performing facilities. Here are highlights of proposed changes along with DPC’s commentary: Patient Satisfaction Survey Scores To Count Toward QIP Payment Reductions: For several years now, dialysis facilities have administered the “CAHPS” survey of patient experience to patients. However, under current regulations, dialysis facilities [...]

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 [...]

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