What is the ESRD QIP?
CMS developed the ESRD QIP to be the nation’s first pay-for-performance (also known as “value-based purchasing”) quality incentive program as mandated by the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) section 153(c). This first-of-its-kind program provides the ESRD community with the opportunity to enhance the overall quality of care that ESRD patients receive as they battle this devastating disease.
From the CMS ESRD QIP website
The Centers for Medicare & Medicaid Services (CMS) administers the End-Stage Renal Disease (ESRD) Quality Incentive Program (QIP) to promote high-quality services in outpatient dialysis facilities treating patients with ESRD. The first of its kind in Medicare, this program changes the way CMS pays for the treatment of patients with ESRD by linking a portion of payment directly to facilities’ performance on quality of care measures. These types of programs are known as “pay-for-performance” or “value-based purchasing” (VBP) programs.
The ESRD QIP will reduce payments to ESRD facilities that do not meet or exceed certain performance standards. The maximum payment reduction CMS can apply to any facility is two percent. This reduction will apply to all payments for services performed by the facility receiving the reduction during the applicable payment year (PY).
Payment reductions result when a facility’s overall score on applicable measures does not meet established standards. CMS publicly reports facility ESRD QIP scores; these scores are available online on Dialysis Facility Compare. In addition, each facility is required to display a Performance Score Certificate that lists its Total Performance Score, as well as its performance on each of the quality measures identified for that year.
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 full details about the ESRD QIP, go directly to the CMS ESRD QIP website.
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