Dialysis Center Productivity Accelerated after 2011 Payment Reform without Compromising Quality of Care

Stephens J Mark,Thamer Mae,Barrus David,Cotter Dennis,Wish Jay B,Ma Martin J

doi:10.23937/2572-3286.1510062

Abstract

In January 2011, the Centers for Medicare & Medicaid Services (CMS) introduced the End-Stage Renal Disease Prospective Payment System (ESRD PPS) with the goal of creating strong economic incentives for Medicare dialysis providers to improve efficiency in the delivery of dialysis treatments, but without compromising quality of care. To date, no formal evaluations have been published of the impacts of the new payment reforms on dialysis center efficiency in the quantity and quality of care delivered in the pre vs. post PPS era. Our objective was to examine whether the goal of improved efficiency in the delivery of dialysis was achieved without compromise to quality of care in the four years following implementation of the End Stage Renal Disease Prospective Payment System (ESRD PPS) in 2011.

Highlights

End Stage Renal Disease (ESRD) is defined as a permanent state of kidney disease severe enough to require chronic kidney replacement therapy to sustain life
Enactment of the ESRD Prospective Payment System (PPS) appears to have achieved the objective of improved dialysis center productivity without compromising quality
Quality of care output metrics for each facility were sourced from the annual Dialysis Facility Reports, which are created under contract to Centers for Medicare & Medicaid Services (CMS) to provide dialysis facilities, consumers, and the public with information on patient characteristics, treatment patterns, hospitalization, mortality, and transplantation patterns in Medicare certified dialysis facilities [13]

Summary

Introduction

End Stage Renal Disease (ESRD) is defined as a permanent state of kidney disease severe enough to require chronic kidney replacement therapy (dialysis or kidney transplantation) to sustain life. In January 2011, the Centers for Medicare & Medicaid Services (CMS) introduced the End-Stage Renal Disease Prospective Payment System (ESRD PPS) with the goal of creating strong economic incentives for Medicare dialysis providers to improve efficiency in the delivery of dialysis treatments, but without compromising quality of care. No formal evaluations have been published of the impacts of the new payment reforms on dialysis center efficiency in the quantity and quality of care delivered in the pre vs post PPS era. Our objective was to examine whether the goal of improved efficiency in the delivery of dialysis was achieved without compromise to quality of care in the four years following implementation of the End Stage Renal Disease Prospective Payment System (ESRD PPS) in 2011

Objectives

Methods

Results

Conclusion