ESRD Quality Incentive Program

In 2011 the Centers for Medicare & Medicaid Services (CMS) implemented a new system of payment for dialysis providers, the Prospective Payment System (PPS) which bundles payment for certain dialysis services. To guard against any potential unintended consequences and a decline in the quality of care under the new ESRD bundled payment system, CMS developed the ESRD Quality Incentive Program (QIP), CMS’s first national value-based purchasing program. Under contract with CMS, Arbor Research has provided support to CMS for the implementation of the ESRD QIP since 2010.

Under the current contract awarded under the MIDS contracting vehicle, Arbor Research provides support to CMS in assessing policy options and implementing algorithms for the calculation of measures, performance scores, and payment reductions. In order to assist CMS with the rulemaking process, the study team manages an annual preview and comment period and validates the work of a contractor responsible for calculating the official scores and reductions used to determine payments. The work of the Arbor Research study team equips CMS with objective data analyses in order to arrive at policy decisions that achieve the goals of continuing to improve the quality of dialysis care while delivering care more efficiently for all ESRD patients.