ESRD Data Systems
The Centers for Medicare & Medicaid Services (CMS) established the End-Stage Renal Disease (ESRD) Quality Initiative Program (QIP) as part of its ongoing efforts to improve the quality of dialysis care provided to ESRD patients. This initiative supports quality improvement efforts among providers and makes available quality information that will enable patients to participate in making health care decisions.
The backbone of CMS’s ESRD information system is CROWNWeb—the Consolidated Renal Operations in a Web-Enabled Network. ESRD networks and dialysis facilities use CROWNWeb to enter and submit patient and clinical quality of care data to CMS.
- Consolidated Renal Operations in a Web-enabled Network (CROWN) is a Web-based data-collection system mandated by CMS to enable dialysis facilities to meet portions of the Conditions for Coverage for ESRD Dialysis Facilities. CROWNWeb helps the renal community transition from a legacy paper-based data-collection method to an electronic “always on” format. The system is designed to help improve patient care efforts by reducing the time it takes CMS to produce clinical performance results. CROWNWeb functions as an important data source for ESRD QIP performance measures.All Medicare-certified dialysis facilities, as well as Renal transplant and Veterans Administration facilities, can submit ESRD program administrative and clinical data to CMS in CROWNWeb.
- The Medicare ESRD Program instituted legislatively mandated changes in 2011 for dialysis services. The ESRD program now operates under a fully bundled, case-mix adjusted prospective payment system and has implemented Medicare’s first-ever mandatory pay-for-performance program: the ESRD Quality Incentive Program.Facilities that do not meet or exceed performance standards will be subject to a payment reduction of up to two percent depending on how far their performance deviates from the standards. These standards and measures will be made public for people to compare facility performance when choosing dialysis centers.The ESRD QIP payment adjustments will apply to payments for outpatient maintenance dialysis items and services furnished to Medicare beneficiaries by ESRD.
- In 2004, CMS partnered with Agency for Healthcare Research and Quality (AHRQ) to develop a Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey for ESRD patients who receive in-center hemodialysis from dialysis facilities. AHRQ and CMS developed and tested the In-Center Hemodialysis (ICH) CAHPS Survey in 2005. The ICH CAHPS Survey is designed to measure the experiences of people receiving in-center hemodialysis care from Medicare-certified dialysis facilities. The ICH CAHPS Survey measures were endorsed by the National Quality Forum (NQF) in 2007.
PII/PHI and HIPAA
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