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ESRD Quality Incentive Program - Measuring Quality

Guidance for the measures, scoring methodologies, and payment-reduction ranges applicable to each Payment Year (PY).

The Centers for Medicare & Medicaid Services (CMS) develops rules that specify the measures, scoring methodologies, and payment-reduction ranges applicable to each Payment Year (PY).  For more information on the rules and regulations for the End-Stage Renal Disease (ESRD) Quality Incentive Program (QIP), please visit the Laws & Regulations page. Measures for the PYs 2027 and 2028 ESRD QIP are in the tables below:

Table 1: PYs 2027 and 2028 Clinical Care Measure Domain

Measures

Kt/V Dialysis Adequacy Topic:

  • Adult Hemodialysis (HD) Kt/V
  • Adult Peritoneal Dialysis (PD) Kt/V
  • Pediatric HD Kt/V
  • Pediatric PD Kt/V
Standardized Transfusion Ratio (STrR)

Vascular Access Type: Hemodialysis Vascular Access: 

  • Long-term Catheter Rate

 

Table 2: PYs 2027 and 2028 Care Coordination Measure Domain

Measures
Standardized Readmission Ratio (SRR)
Standardized Hospitalization Ratio (SHR)
Percentage of Prevalent Patients Waitlisted (PPPW)
Clinical Depression Screening and Follow-Up

 

Table 3: PYs 2027 and 2028 Safety Measure Domain

Measures
National Healthcare Safety Network (NHSN) Blood Stream Infection (BSI) in Hemodialysis Patients

 

Table 4: PYs 2027 and 2028 Patient and Family Engagement Domain

Measures
In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems (ICH CAHPS) Survey

Table 5: PYs 2027 and 2028 Reporting Measure Domain Measure(s)

Measures
Hypercalcemia
Medication Reconciliation (MedRec)
COVID-19 Vaccination Coverage Among Healthcare Personnel (HCP)

CMS ESRD Measures Manual

The CMS ESRD Measures Manual (Manual) contains detailed specifications on the ESRD QIP measures and dialysis facility measures reflected in the Care Compare tool on Medicare.gov. The Manual is designed to provide transparent and detailed descriptions of how ESRD QIP and Care Compare measures are calculated, offering the public a comprehensive understanding of how CMS evaluates the quality of care provided by dialysis facilities. Links to the Manuals and other supporting documents are listed below:

 

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: July 28, 2020

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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.