The Centers for Medicare & Medicaid Services issued a final rule this week that would change how Medicare pays for dialysis services for Medicare beneficiaries who have end-stage renal disease.
The proposed rule would also establish a new quality incentive program that would link a facility’s payments to performance standards. The QIP is the first pay-for-performance program in a Medicare fee-for-service payment system.
Both the new prospective payment system and the proposed QIP were required by the Medicare Improvements for Patients and Providers Act of 2008. The law requires the ESRD PPS to pay dialysis facilities a single bundled rate for renal dialysis services and home dialysis, while the proposed QIP creates payment incentives for them to take steps to improve patient outcomes.
Currently, Medicare pays for certain dialysis services under a partial bundled rate, referred to as the composite rate.
The QIP proposed rule also discusses options for making individual facility performance scores available both to dialysis patients and to the general public as required by the law.
CMS will accept comments on the QIP proposed rule until Sept. 24, 2010, and will respond to them in a final rule to be issued later this year.
To view the ESRD PPS Final Rule and the QIP Proposed Rule, see: http://www.ofr.gov/OFRUpload/OFRData/2010-18466_PI.pdf or www.ofr.gov/inspection.aspx