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Medicare Proposal Ties Stricter Quality Measures to ESRD Payments

Cheryl Clark, for HealthLeaders Media, July 10, 2012

"Poor management of anemia and inadequate dialysis, for example, can lead to avoidable hospitalizations, decreased quality of life, and death. Infections are also a leading cause of death and hospitalization among hemodialysis patients, but there are proven infection control methods that have been shown effective in reducing morbidity and mortality," the rule states.

The new measures include:

  • Reporting to the Centers for Disease Control and Prevention's National Healthcare Safety Network of events such as infections.
  • A measure for evaluating how well dialysis centers manage patients' anemia, which can be an unintended consequence of treatment.
  • A survey administered by a third party to gauge patients' experiences as they undergo treatment, similar to Medicare's HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey.
  • Clinical quality of care, in which the centers are evaluated based on whether the centers achieve in their patients hemoglobin levels greater than 12 g/dL; hemodialysis adequacy based on urea reduction ratios; whether they receive the most effective type of vascular access; and whether patients are monitored for phosphorous and calcium level abnormalities.
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