Novel interventions and therapeutic agents being developed by academia and the pharmaceutical industry hold promise for the prevention and treatment of acute kidney injury (AKI). But questions about the design of clinical trials for these agents must be addressed before nephrologists can begin to study the therapies—and bring them to patients.
Nephrology researchers and clinicians met with National Institute of Diabetes, Digestive and Kidney Disease (NIDDK) staff, industry representatives, and Food and Drug Administration (FDA) officials in December at the “AKI Clinical Trial Design Workshop,” organized and hosted by the NIDDK.
AKI is a common condition associated with high mortality,
Finalizing performance standards and scoring methodology for the Quality Improvement Program (QIP), the Centers for Medicare and Medicaid Services (CMS) issued a QIP Final Rule on December 29, 2010. CMS will implement the QIP—the first-ever mandatory pay-for-performance program within CMS—on January 1, 2012. The second major change to the Medicare ESRD program, CMS will institute the QIP exactly one year after implementing the new bundled Prospective Payment System (PPS) last month.
CMS sought public comment on a QIP Proposed Rule during the summer of 2010. ASN formed a Task Force that analyzed and provided feedback on this initial proposal composed
The Centers for Medicare and Medicaid Services (CMS) last month released its long-awaited rule finalizing changes to the End-Stage Renal Disease Program (ESRD) payment system and the Quality Incentive Program (QIP). The final rule outlined modifications to the ESRD prospective payment system (PPS) for 2012, and it cemented adjustments—as well as major additions—to the QIP program across 2013 and 2014.
The ESRD PPS/QIP final rule came on the heels of another piece of CMS regulation that has been much anticipated by the medical community: the Accountable Care Organization (ACO) final rule, released in late October. The ASN Public Policy Board
The kidney community enters 2014 on the heels of receiving some good news—and some bad news—regarding dialysis payments in the Medicare ESRD program.
First, the good news: in its November 22, 2013, final rule, the Centers for Medicare & Medicaid Services (CMS) responded to concerns raised by ASN and other stakeholders that a proposed 12% cut to dialysis payments could impede patient access to care and jeopardize the quality of care. The agency acted to delay the cuts for two years, rather than having them take effect starting this month, responding to calls from the kidney community to phase in
The Centers for Medicare and Medicaid Services (CMS) released a proposed rule on July 2, 2012, that addresses dialysis care. The ASN Quality Metrics Task Force is analyzing the proposed rule and, with the ASN Public Policy Board, will provide input to CMS on behalf of ASN members.
The proposed rule updates Medicare’s dialysis payment system administered through the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS). The Prospective Payment System pays a predetermined, fixed amount for all services related to each dialysis treatment. This is also known as a “bundled” payment system.
Since 2007, physicians and other eligible health professionals have been eligible to receive bonus Medicare payments for voluntarily reporting data to the Physician Quality Reporting System (PQRS) program. Starting in 2013, that program will no longer be voluntary, and every physician and other health professional with a National Provider Identifier (NPI) number should be aware of important changes to the PQRS that will affect their Medicare payments (Table 1).
The PQRS is a congressionally mandated program operated by the Centers for Medicare & Medicaid Services (CMS). The Tax Relief and Health Care Act of 2006 first authorized the
The recently released Government Accountability Office (GAO) report, “End-Stage Renal Disease: Reduction in Drug Utilization Suggests Bundled Payment is Too High,” has generated controversy within the kidney community.
Focused on erythropoiesis-stimulating agent (ESA) utilization, the report comes at a time when a potential rebasing of the bundled payment rate is already creating uncertainty and concern. The report introduces additional controversy by recommending reducing that payment rate quickly and dramatically.
As the Medicare ESRD Prospective Payment System—more commonly known as “the bundle”—and the Quality Incentive Program (QIP) enter their third year of operation, rebasing the bundle is a front-and-center issue for
The deadline for nephrologists and dialysis facilities to apply to become an ESRD Seamless Care Organization (ESCO)—the first-ever disease-specific Medicare Shared Savings Program—has come and gone. As of press time, it appears that the Centers for Medicare and Medicaid Services (CMS) received fewer applications than the agency and the community had once hoped.
CMS had originally stated that it expected between 10 and 15 unique ESCOs to participate, with representation from all dialysis provider organizations/facility types and geographic areas—and that it would consider making more than 15 awards “if a compelling reason exists to do so.” No official count of
Patients with kidney disease may see several positive changes to their ESRD care options in 2016. A bipartisan “Chronic Care Working Group” formed by the Senate Finance Committee recently released a white paper outlining policy changes they are interested in enacting this year—including several components related specifically to kidney care.
After soliciting input in June 2015 from ASN and other stakeholders in the medical community regarding opportunities to improve the care of people with chronic conditions and reduce related Medicare expenditures, the committee received more than 1000 suggestions. The white paper narrowed down the feedback to approximately 20 policy options,
The government agency charged with developing new health care payment and service delivery models—CMS and its Center for Medicare and Medicaid Innovation (CMMI)—recently announced the Comprehensive ESRD Care Initiative.
The announcement marks the end of months of speculation about when—and whether—the Innovation Center would announce a coordinated care model for kidney care. ASN, along with many other stakeholders in the kidney community, advocated in support of such a model. However, as of press time, numerous details about the Innovation Center’s vision for the program remained unclear to many in the kidney community.