Meeting the 2012 QIP (Quality Incentive Program) Clinical Measures: Strategies for Dialysis Centers

Abstract

The US Centers for Medicare & Medicaid Services end-stage renal disease Quality Incentive Program (QIP) is a pay-for-performance program that reduces dialysis center payments by up to 2% for suboptimal patient care. In January 2012, the performance year began for payment year 2014, bringing significant changes to the QIP by introducing 6 quality indicators (3 clinical measures and 3 reporting measures) and a new scoring methodology. To succeed under the new QIP, dialysis facilities must meet 3 clinical measures that assess anemia management, hemodialysis adequacy, and vascular access type in patients receiving dialysis treatment, as well as 3 reporting measures that involve the reporting of dialysis safety events, attestation of administering a patient satisfaction survey, and attestation of patient mineral metabolism monitoring. To help dialysis providers reach these targets, this article provides an overview of the 3 clinical measures and the QIP scoring methodology, as well as a description of patient claims that are excluded when the scores for these measures are calculated. Strategies and solutions that address provider- and patient-related factors also are discussed to help ensure that more dialysis centers meet the new QIP clinical measures for performance year 2012/payment year 2014.