Author: IPRO

How Does the ESRD Network Partner with Facilities to Improve Patient Care?

Under contract with CMS, ESRD Networks are charged with achieving healthcare transformation, promoting the National Quality Strategy, and supporting the Health and Human Services Secretary’s priorities, by working with dialysis providers, government agencies, ESRD stakeholders, patients, family members and care partners to reach CMS set goals. The Network strives to achieve these goals through activities that include:

  • conducting directed quality improvement activities focused on patient care,
  • maintaining a patient registry,
  • assisting with emergencies,
  • providing educational materials, and
  • investigating patient grievances.

On December 1, 2017, all 18 ESRD Networks across the country began a new contract year.

Do you want to learn more about the work of the Network?

Medicare Part D: Time to Review

Medicare offers prescription drug coverage to everyone with Medicare. If your patients decide not to get Medicare drug coverage when they are first eligible, they may be asked to pay a late enrollment penalty unless they have other creditable prescription drug coverage or are receiving Medicare’s Extra Help.

Every year, Medicare’s open enrollment period is October 15 – December 7. Medicare health and drug plans can make changes each year. These changes could affect the cost, coverage, and the providers and pharmacies in their networks. You can assist your patients by discussing their Medicare Part D coverage and timelines for the ESRD coordination of benefits period to ensure that they are prepared for the year to come.

To research Medicare drug plans use the Medicare Plan finder at: https://www.medicare.gov/find-a-plan/questions/home.aspx

ESRD PPS: Updates to Policies and Payment Rates

CMS issued a final rule that updates payment policies and rates under the ESRD Prospective Payment System (PPS) for renal dialysis services furnished to beneficiaries on or after January 1, 2018. In addition, this rule finalizes updates to the acute kidney injury dialysis payment rate for renal dialysis services, as well as updates to the ESRD Quality Incentive Program for payment years 2019, 2020, and 2021. CMS projects that the updates for Calendar Year (CY) 2018 will increase the total payments to all ESRD facilities by 0.5 percent compared with CY 2017. For hospital-based ESRD facilities, CMS projects an increase in total payments of 0.7 percent, while for freestanding facilities, the projected increase in total payments is 0.5 percent.

The final rule also includes:

  • Update to the ESRD PPS base rate
  • Annual update to the wage index and wage index floor
  • Update to the outlier policy

See the full text of this excerpted CMS Fact Sheet (issued October 27).

Why Facility Data Reports Should Be Checked

CMS established the ESRD Quality Incentive Program (QIP) as part of its ongoing efforts to improve the quality of dialysis care provided to ESRD patients.

Annual Dialysis Facility Reports (DFRs) and Quarterly Dialysis Facility Compare (QDFC) Reports are made available to facilities, State Survey Agencies, and Regional Offices online at dialysisdata.org. Only authorized users can access the reports.

Facilities can use the DFR and QDFC reports to assist in their quality improvement efforts; state surveyors use the DFR data when deciding which facilities to survey. Facilities are given a chance to preview and comment on these reports. The quality measures from the reports are posted on the Dialysis Facility Compare website, which is used by patients to review and compare characteristics and quality information on approximately 6,500 dialysis facilities in the United States.

Dialysis facility staff are encouraged to review the facility’s data reports on a regular basis. For information on how to access these reports, visit the IPRO ESRD Network Program help portal.

Shortcut to Resources for National Healthcare Safety Network (NHSN)

Have you been to the National Healthcare Safety Network (NHSN) section of the Network web site? You’ll find a shortcut to your most frequently needed NHSN resources that include:

  • Required Training
  • Enrollment Steps
  • NHSH Event Protocol
  • NHSN Dialysis Event Surveillance Data
  • CMS ESRD QIP Rule Report
  • Health Care Personnel Safety Components
  • NHSN Contact Information

New Priorities and Goals Planned for ESRD Stakeholders

The Department of Health and Human Services (HHS) National Quality Strategy (NQS) is a national effort to align public- and private-sector stakeholders to achieve better health and healthcare for all Americans. It was developed “through a transparent and collaborative process with input from a range of stakeholders. More than 300 groups, organizations, and individuals, representing all sectors of the health care industry and the general public, provided comments.”

The Centers for Medicare & Medicaid Services (CMS) contracts with End Stage Renal Disease (ESRD) Networks to implement the NQS principles and HHS Secretary’s priorities in the ESRD community. Starting in December 2017, Networks will launch a set of new quality improvement activities, data reporting requirements, and educational programs that reflect updated priorities and goals.

HHS Secretary’s Priorities

  1. Reform, Strengthen, and Modernize the Nation’s Health Care System
  2. Protect the Health of Americans Where They Live, Learn, Work, and Play
  3. Strengthen the Economic and Social Well-Being of Americans Across the Lifespan
  4. Foster Sound, Sustained Advances in the Sciences
  5. Promote Effective and Efficient Management and Stewardship

CMS Goals

  1. Empower patients to make decisions about their health care
  2. Usher in a new era of state flexibility and local leadership
  3. Support innovative approaches to improve quality, accessibility, and affordability
  4. Improve the CMS customer experience

November is American Diabetes Month

According to the Centers for Disease Control and Prevention (CDC), more than 30 million children and adults in the United States are living with diabetes. At least 1 out of 3 people will develop diabetes in their lifetime. The American Diabetes Association has selected the month of November to raise awareness of the disease and its serious complications. The following resources can be helpful for dialysis staff and patients to discuss the importance of diabetes prevention and control:

How to Prevent, Diagnose, and Treat Hemodialysis Catheter-Related Infections

The best way to prevent infectious complications in dialysis patients is to avoid the use of central-venous catheters (CVC), when possible. However, this is not possible for some patients, and in those cases the adoption of prophylaxis protocols, early diagnosis and effective treatment of infectious complications are essential to improve outcomes. These are some of the conclusions reported in an article in the Journal of Vascular Access, which provides a comprehensive review of literature related to hemodialysis catheter – related infections as well as a discussion of prevention, diagnosis criteria and management of CVC-related infections in hemodialysis patients.

Emergency Planning: Can you answer these questions?

Are you confident that all members of your staff and your patients are aware of what to do in an emergency? Are you prepared to review your facility’s emergency planning with a state surveyor? Can you, your staff, and your patients:

Describe the facility’s emergency preparedness program?

  • Staff and patients should be able to explain what they would do in an emergency, based upon what they have learned in training and drills.

Know where to find the facility’s emergency plan and documentation?

  • Staff should know where the plan is, and who the leads are in an emergency.
  • Patients should have, at least, an emergency contact sheet and a copy of their dialysis orders.

If you answered NO to either of these questions, find out who the emergency lead is at your facility, and work with them to ensure that you, your staff, and your patients are prepared.

For more information visit the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response (HHS ASPR) Technical Resources, Assistance Center, and Information Exchange (TRACIE)’s Tools and Templates webpage at https://asprtracie.hhs.gov/technical-resources/50/dialysis-centers/47#plans-tools-and-templates.

2017 Fall ICH CAHPS Data Collection is Starting Up in October

Starting this month dialysis patients will be mailed pre-notification letters in preparation for the distribution of the upcoming ICH CAHPS fall 2017 survey. The surveys will be sent to patients in two mailings; one on November 3 and the second on December 1. Data collection will continue until January 12, 2018. The survey administration specifications can be reviewed at Survey and Protocol.

For more information or additional questions, please contact the Coordination Team via email at ichcahps@rti.org or call 1-866-245-8083.

Encourage Your Patients to Review Their Options: Medicare Open Enrollment is October 15 – December 7

Helpful resources for your patients: