ESRD Quality Incentive Program (QIP)

Overview

The Centers for Medicare & Medicaid Services (CMS) has completed implementation of the End-Stage Renal Disease (ESRD) Quality Incentive Program (QIP) designed to encourage the delivery of high-quality services in dialysis facilities. The ESRD QIP is one of several pay-for-performance or “value-based purchasing” initiatives that CMS has undertaken to transform the healthcare payment system to one that considers the quality of services provided to beneficiaries, not just the quantity of services provided.

Each dialysis facility must post a Performance Score Certificate that documents the facility’s performance on the ESRD QIP including their Total Performance Score, scores on individual measures, and comparisons to the national average. Facilities must display their Performance Score Certificate within five business days of receiving notice from CMS that the certificate is available. The certificate must be posted for the entire year (January 1, 2014-December 31, 2014) in an area where it is easily visible to beneficiaries and their families or caregivers. These certificates must be updated and posted annually.

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 Quality Incentive Program Process

Quality Incentive Program Process

ESRD QIP was established in the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) by adding Section1881(h) to the Social Security Act

  • CMS publishes a Proposed Rule via Notice of Proposed Rulemaking (NPRM) in the Federal Register
  • Public has a 60-day period to comment
  • CMS takes public comment into consideration and publishes a Final Rule in the Federal Register

ESRD QIP Rulemaking

Notice of Proposed Rulemaking for PY 2017 and 2018

ESRD Quality Incentive Program Educational Resources

MLN Connects Payment Year 2016 Final Rule

QIP & ESRD Data Collection Systems Presentation

Information on current ESRD QIP measures and specifications

What resources are available to answer facilities questions?

 

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