CMS Proposes 2018 Policy and Payment Rate Changes for End-Stage Renal Disease Facilities

Proposed rule builds patient-centered system of care to increase competition, quality and care 

The Centers for Medicare & Medicaid Services (CMS) today issued a proposed rule that would update payment policies for the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS). The ESRD PPS proposed rule is one of several for calendar year 2018 that reflect a broader strategy to relieve regulatory burdens for providers; support the patient-doctor relationship in healthcare; and promote transparency, flexibility, and innovation in the delivery of care.

“CMS is committed to transforming healthcare to empower patients and doctors so that they can make the best decisions about their health,” said CMS Administrator Seema Verma. “A focus on patient-centered care allows providers to direct their time and resources to improving health outcomes for all patients rather than complying with burdensome regulations from Washington, D.C.”

This proposed rule ensures program stability through payment incentives that focus on improved quality of care at dialysis facilities. The rule covers payment rates for renal dialysis services, including updates to acute kidney injury (AKI), furnished to beneficiaries on or after January 1, 2018.

The ESRD Quality Incentive Program (QIP) proposed changes are for payment years 2019, 2020, and 2021, and a number of key dialysis data methodologies and quality measures. The proposed rule also requests comment on how to include individuals with acute kidney injury in the ESRD Quality Improvement Program.

These updates will help reduce regulatory burdens and allow providers to improve outcomes based on the unique needs of their patients. In addition to the proposed rule, CMS is releasing a Request for Information to welcome continued feedback on the Medicare program. CMS is committed to maintaining flexibility and efficiency throughout Medicare. Through transparency, flexibility, program simplification, and innovation, we aim to transform the Medicare program and promote the availability of high-value and efficiently-provided care for its beneficiaries.

For a fact sheet on the proposed rule, please visit: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2017-Fact-Sheet-items/2017-06-29.html

The ESRD proposed rule (CMS 1674-P) can be downloaded from the Federal Register at: https://www.federalregister.gov/public-inspection/

For more information about the End Stage Renal Disease Program, please visit:  https://www.cms.gov/Center/Special-Topic/End-Stage-Renal-Disease-ESRD-Center.html

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