On July 1, CMS also proposed updates to its performance measures under the ESRD Quality Incentive Program (QIP) for payment years 2013 and 2014. The ESRD QIP is a Medicare savings program that will reduce payments by up to two percent to dialysis facilities who fail to meet certain performance measures. Performance measures during the first year of the ESRD QIP (2012) include a target hemoglobin range of 10–12 g/dL, and a hemodialysis adequacy measure.
CMS is proposing to eliminate the bottom level of the target hemoglobin range from its performance measures in 2013 to coincide with recent recommendations from the U.S. Food and Drug Administration (FDA) on erythropoiesis-stimulating agent (ESA) use in kidney patients. The FDA released findings in June that showed ESA use by kidney patients can lead to increased risks of stroke, adverse cardiovascular reactions and death. Accordingly, ESA labels now instruct doctors to use lower doses of ESAs based on a patient’s individual needs, rather than to meet a target hemoglobin range.
For 2014, CMS has proposed a total of eight performance measures, including new clinical measures to evaluate a facility’s patient infection and hospitalization rates, as well as non-clinical measurements such as evaluating whether a facility provides a patient experience survey.
AKF supports the establishment of the ESRD QIP and will continue to monitor the implementation of QIP and consideration of future measures. AKF will file comments on the rule. For more information, please visit AKF's Advocacy website.