Quality incentive program for ESRD: a review

The ESRD quality incentive program changes again in 2014. There will be more quality measures added and more complex scoring. A recent review in Kidney International is a must read for all.

Few take home points:
1. Most performance scores will depend on percentage of ESA use in Hgb> 12g/dl patients, URR>65%, and vascular access type.
2. Vascular access infection and hospitalization rate will not be added this time around
3. Dialysis safety events, patient satisfaction scores and monthly serum ca and phos will be the three reporting measures being used.
4. The scoring system used will be TPS( total performance score).  The range is 0-100 from all the measures. The details of this scoring are described in the article.
5. Payment reductions will happen as such. 53-100 point score- no reduction. 43-52 would lead to a 0.5% reduction. 33-42  would lead to a  1% reduction, 23-32 would lead to a 1.5% reduction and <23 would be a 2.0% reduction.

A must read for all nephrologist!