Quality Incentive Program

The ESRD Quality Incentive Program (QIP) is described in Section 1881(h) of the Social Security Act, as added by Section 153(c) of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), and is a program designed to promote patient health by providing a financial incentive for renal dialysis facilities to deliver high-quality patient care.

Section 1881(h): Authorizes payment reductions if a facility does not meet or exceed the minimum Total Performance Score (TPS) as set forth by CMS Allows payment reductions of up to 2%.  

MIPPA requires the Secretary of the Department of Health and Human Services (HHS) to create an ESRD QIP that will:

  1. Select measures

  2. Establish performance standards that apply to individual measures

  3. Specify the performance period for a given PY

  4. Develop a methodology for assessing total performance of each facility based on performance standards for measures during a performance period

  5. Apply an appropriate payment percentage reduction to facilities that do not meet or exceed established total performance scores

  6. Publicly report results through Web sites and facility posting of performance score certificates (PSC)

ESRD Dialysis Facilities in Network 4 should have a complete understanding and knowledge of the ESRD QIP.  This awareness may help prevent reduction in payments to ESRD facilities that do not meet or exceed certain performance standards. Facilities must also be aware of the two percent maximum payment reduction CMS can apply to any facility, and the fact that this reduction will apply to all payments for services performed by the facility receiving the reduction during the applicable payment year (PY). The foundation, principles and mechanisms guiding the ESRD QIP will remain the same over time, but the program’s specific quality measures, standards, weights and formulas will change from year to year.

For more information about the ESRD QIP, visit http://www.cms.gov/Medicare/Quality-Initiatives-patient-Assessment-Instruments/ESRDQIP on the CMS website.



QIP RESOURCES

DIALYSIS FACILITY REPORTS

University of Michigan Kidney Epidemiology & Cost Center carries out epidemiological, clinical, medical outcomes, public policy, and economic research relating to End-Stage Renal Disease (ESRD), Chronic Kidney Disease (CKD), and organ transplantation. Annually, the Center, along with Arbor Research Collaborative for Health, produces the Dialysis Facility Reports which allow dialysis providers to compare the characteristics of their facility’s patients, patterns of treatment, and patterns in transplantation, hospitalization, and mortality to local and national averages.

Beginning in 2010, the distribution of the DFRs shifted from paper-based to electronic-based, via the secure website www.dialysisreports.org. Each facility has designated a Master Account Holder (MAH) who has the ability to access the DFRs and assign access to additional facility-level users.  For more information on accessing your facility's DFR or about MAH credentialing, please contact the Quality Insights Renal Network 4 office.

CMS PERFORMANCE MEASUREMENT

Looking for information about national performance measures? The following information can help.

Dialysis Facility Reports (DFRs)

Provides a way for facilities to compare the characteristics of their patients, patterns of treatment, and patterns in transplantation, hospitalization, and mortality to local and national averages.

ESRD Quality Incentive Program (QIP)

The ESRD Quality Incentive Program (QIP) is described in Section 1881(h) of the Social Security Act, as added by Section 153(c) of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), and is a program designed to promote patient health by providing a financial incentive for renal dialysis facilities to deliver high-quality patient care.