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Healio Nephrology News & Issues

As financial incentives prove ineffective, kidney community takes steps to improve quality

August 18, 2021

Quality improvement is a broad term as it applies to health care, and as a major payer for the End-Stage Kidney Disease Program, CMS has tinkered with efforts to influence clinical performance and reduces costs.

Most recently, criticism has been leveled at the agency concerning the management of the ESRD Quality Incentive Program (QIP), a 10-year effort using a pay-for-performance approach to improve the quality of care of patients on hemodialysis.

“I believe the QIP is fundamentally flawed because it is entirely penalty based,” Timothy A. Pflederer, MD, an interventional nephrologist and president of the Renal Physicians Association, told Nephrology News & Issues. “The opportunity of reward is a more powerful motivator than that of penalty avoidance.”

The QIP is the first program in Medicare that pays for the treatment of patients by linking a penalty– up to 2% of the payment a dialysis facility receives for Medicare patients – directly to the performance of facilities on clinical performance measures (CPMs).

CMS publicly reports facility ESRD QIP scores and payment adjustments on Dialysis Facility Compare on the Medicare.gov website. In addition, each facility is required to display a performance score certificate that lists its total performance score.

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