NN&I - January 2012

Renal Policy Reporting measure scoring Measure 1 reporting of dialysis safety events to the NHSN is scored based on the extent of the dialysis facilitys participation Facilities that do not enroll in the program in 2012 will receive no points for this measure Five points are earned if the dialysis unit enrolls and receives the required training during 2012 The full 10 points requires both enrollment and training and three consecutive months of reporting of data prior to March 31 2013 The second reporting measure is the use of the ICH CAHPS patient satisfaction tool Facilities that attest that they are administering the survey during 2012 would receive 10 points The lack of such attestation would yield zero points The third measure is reporting on performance of monthly calcium and phosphorus testing for all Medicare patients Attestation that this is accomplished results in 10 points Failure to do so will yield zero points Total performance score The Total Performance Score TPS is calculated on a 0 100 scale based on 90 weighting for the clinical measures and 10 for reporting measures Summing the three clinical measures will result in a score of 0 30 the three reporting measures will produce a summed score of 0 30 The total clinical score multiplied by three results in a 90 weighting to a scale of 0 90 Dividing the total reporting score by three deflates the reporting measure weighting to 10 The final TPS is simply the total clinical score added to the final reporting score with a scale of 0 100 produced The CMS proposed formula achieves the same results Total Performance Score 300 hemoglobin greater than 12 g dL measure 300 URR hemodialysis adequacy measure 300 vascular access CMS 1577 F 193 type measure 0333 NHSN reporting measure 0333 patient experience survey reporting measure 0333 mineral metabolism reporting measure 10 Effect of the total performance score on payment Depending on the facilitys TPS payment may be reduced up to a maximum of 2 To avoid any payment reduction the TPS must exceed a CMS determined minimum TPS CMS has estimated the minimum score to be 56 the actual minimum score will be released at the end of January Payment reductions are assessed in proportion to how low below the minimum TPS that the facilitys TPS falls see Table 4 Succeeding with the 2014 QIP Certainly high quality care and improved patient outcomes should be the central focus of dialysis centers The CMS ESRD QIP is likely to expand in scope in future years A dialysis facility with a strong focus on quality and well developed quality assessment and performance improvement process will do well Table 4 Payment year 2014 payment reductions Total performance score Percentage payment reduction Above minimum TPS No reduction 1 10 points below minimum 05 11 20 points below minimum 10 21 30 points below minimum 15 30 points below minimum 20 in the QIP A mult idi s c ipl ina r y approach to quality management with active engagement of nephrologists is the clearest path to success Because the QIP has important financial implications regular tracking of results throughout the performance period with estimation of financial impact is critical for success References 1 http www ofr gov OFRUpload OFRData 2011 28606_ PI pdf accessed November 3 2011 Visit NN Is newly redesigned website www NephrologyNews com Improved organization of renal related news health care news More blogs Revised Special Sections and Reports that includes government studies and NN I surveys Updated Calendar section of dialysis meetings Easy access to NN I archives and webinars Dont forget to sign up for our free three times a week eNewsletter Nephrology News Issues January 2012 Subscribe to our free eNewsletter at www NephrologyNews com 26