Friday, December 31, 2010

CMS issues final rule for dialysis facility quality incentive program

The Centers for Medicare & Medicaid Services issued a final rule for the Quality Incentive Program that will establish performance standards for dialysis facilities and provide payment adjustments to individual End-Stage Renal Disease facilities based on how well they meet these standards.

The final rule establishes the ESRD QIP performance standards, sets out the scoring methodology CMS will use to rate providers quality of dialysis care, and establishes a sliding scale for payment adjustments based on the facilities performance.  CMS will assess each dialysis facility on how well its performance meets the standard for each measure and will calculate each facilities Total Performance Score. The maximum Total Performance Score a facility can achieve is 30 (10 points per measure).  Facilities that do not meet or exceed performance standards will be subject to a payment reduction of up to 2% depending on how far their performance deviates from the standards.

CMS finalized three measures as the initial measure set during the first program year.  Two of these measures are designed to assess whether patients hemoglobin levels are maintained in an acceptable range, while the third measures the effectiveness of the dialysis treatment in removing waste products from patients blood.   
In future years CMS may add quality measures and establish additional performance standards that facilities will need to meet to receive full payment for the services they furnish to Medicare beneficiaries.

Read entire article here

Tuesday, December 28, 2010

Dialysis Data, Once Confidential, Shines Light on Clinic Disparities

For years, the government has collected a rich store of data about the performance of individual dialysis facilities. But it has kept nearly all the information secret from those it might benefit most: Patients.

Now ProPublica has obtained this data under the Freedom of Information Act. We are making a comprehensive set of clinic records publicly available  for the first time on our website.

Patients and others can search for a clinic and see how it compares on 15 key measures, ranging from mortality and hospitalization to transplant rates and infection control. Also on the site are historical reports dating to 2002.

Release of the data is long overdue, patient advocates say.

"It gives you a snapshot of what a clinic is about," said Roberta Wager, a past president of the American Association of Kidney Patients who works as a nurse and patient educator at several dialysis clinics in Texas. "This is your life. Wouldn't you want to have everything in your favor?"

There are almost 400,000 Americans who depend on chronic dialysis to do what their failed kidneys cannot, a number that has grown swiftly over the past two decades, spurred by epidemics of obesity and diabetes.

More than 5,000 facilities have sprung up to provide them with care, stretching into the nation's most rural areas and competing for patients in urban and suburban areas.

Patients today have more choice than ever. Yet most pick centers based on convenience, or on what their doctors suggest, with little notion that even clinics within the same communities can have substantial disparities.

In more than 200 counties nationwide, the data show, the gap between facilities with the best and worst patient survival, adjusted for case-mix differences, is greater than 50 percent. In areas such as Allegheny County, Pa., or Franklin County, Ohio, each with upwards of two dozen clinics, the differences are even more substantial, exceeding 200 percent.

There is also wide variability in how often patients at different clinics are hospitalized for septicemia. Although septicemia cases can be unrelated to dialysis, it is a significant risk for patients, who typically have their blood cleaned of toxins three times a week. Nationally, the rate was about 12 percent a year for 2006 to 2008. But in dozens of counties, the spread between facilities with the highest and lowest rates was more than 25 percentage points.

Read entire article here

Monday, December 6, 2010

New York City to Start Organ Ambulances

Renal Business Todays editor Keith Chartier

New York City will start sending out a second ambulance to scenes in which someone may be in danger of dying in order to quickly harvest organs that can be used for transplant.

The federally funded five-month trial will be limited to Manhattan between 4 pm and midnight to adults between 18 and 60 years old, and to people who die of cardiac arrest outside of a hospital.

The development of the program was fraught with ethical concerns, but those behind it felt that organs needed to be obtained sooner outside the hospital before the organ becomes unusable.

To read entire article on Renal Bizblog, click here

Wednesday, December 1, 2010

Making Sugar Count During The Holidays

American Diabetes Association - If you like sweets, one of the most tempting parts of the holidays is the dessert. Even though you have diabetes, you can still fit sweets into your meal plan.

Eating high-sugar foods like cakes, candy, cookies, and pies will make blood glucose rise, so do not just add them to your diet. Instead, substitute small portions of these sweets for other carbohydrates already in your meal plan. For example, if you want a small serving of pumpkin pie, then pass on eating a dinner roll during the main course.
 To view Desserts During the Holidays, click here