Dialysis facilities paid under the end-stage renal disease, or ESRD, prospective payment system will see an overall increase of 2.1% in their Medicare payment rates in 2012, which the CMS estimates should total about $8.3 billion in payments.
Medicare will boost dialysis pay 2.1%
The payment update reflects a marketbasket increase of 3% minus a productivity adjustment of 0.9%, according to the CMS, which issued a final rule for the ESRD payment system (PDF) late Tuesday.
Meanwhile, the rule also made new requirements for the ESRD Quality Incentive Program (QIP), which will affect payment rates in 2013 and 2014. Under the QIP, payments to facilities are reduced if a facility does not achieve a certain total performance score based on its performance for quality-of-care measures. A final rule earlier this year on the initial ESRD QIP affected payments to facilities for 2012 based on their performance regarding anemia-management measures and one measure of dialysis adequacy, the CMS said. The final rule issued Tuesday changes performance measures for 2013 by retiring the anemia-management measure of hemoglobin less than 10 grams per deciliter from the initial measure set.
“CMS believes that new concerns about the safety of ESAs (erythropoiesis-stimulating agents) for dialysis patients strongly argue for providers to work more closely with their patients to develop anemia management strategies that respond to the patient's unique medical issues, rather than adopting a one-size-fits-all approach to care,” Dr. Patrick Conway, CMS chief medical officer and director of the Agency's Office of Clinical Standards & Quality, said in a news release. “This patient-centered approach should result in better treatment outcomes. We plan to monitor hemoglobin levels by facility and to transparently share this information with consumers.”
For 2014, the CMS is retaining one anemia-management measure (hemoglobin level greater than 12 grams per decilter) and the dialysis adequacy measure. The agency is also adding four additional quality measures for that year, including one that measures if a facility administers of patient experience-of-care survey.
The final rule also changes how the CMS will score a facility's performance under the QIP. One change relates to the two-measure framework for 2013, while the other change details how the CMS will score facilities on the six measures adopted for 2014.
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