Medicare Proposal Ties Stricter Quality Measures to ESRD Payments

More than 5,000 dialysis centers around the country would have to work within much stricter quality guidelines under Medicare's proposed incentive payment program for care delivered to patients with end-stage renal disease.

Included in the proposal is that each center's rate of hospital admissions—the adjusted number of patients who required admission to a hospital because of an infection or other adverse event—would be publicly reported in 2015 "to encourage facilities to improve their care."

Several other quality measures would be folded into a formula that determines reimbursement of federal funds to dialysis centers, which now treat more than 547,000 patients with renal disease who undergo dialysis, a cost to Medicare estimated at $8.7 billion for 2013, and $39.46 billion in public and private (insurance and patients' co-payments) spending as of 2008.

The proposed rule states that these measures were picked in the belief that they "are important indicators of patient outcomes and quality of care."