How can CMS improve the quality of dialysis treatment?
Monitoring and evaluating the ESRD QIP
Challenge
CMS administers the End-Stage Renal Disease Quality Incentive Program (ESRD QIP) to promote high-quality services in renal dialysis facilities. In this value-based purchasing program, CMS reduces Medicare payments to renal dialysis facilities by as much as 2% if they do not meet or exceed specific performance standards. The performance standards are revised each year, with adjustments to the measures, methodologies to score facilities, and payment reduction scale. CMS designed the ESRD QIP and the ESRD Prospective Payment System to improve outcomes in facilities that treat patients with ESRD, while at the same time lowering costs for CMS.
Solution
Since 2021, Westat conducts monitoring and evaluation analyses of the ESRD QIP. Our team tracks dialysis quality and outcome measures for all Medicare fee-for-service dialysis patients. We also study the effect of the ESRD QIP on dialysis patients and facilities’ subpopulations with a focus on interactions between the program and patients. Specifically, we are conducting the following tasks:
- Develop and implement annual monitoring and evaluation plans
- Conduct environmental scans and data dashboards to inform the evaluation and monitoring approach
- Use statistical and econometric approaches to evaluate the ESRD QIP on CMS’s priority outcomes
- Develop regular monitoring reports on access to care, quality of care, quality of life, and efficiency of dialysis care among Medicare beneficiaries on dialysis
- Conduct semistructured interviews with dialysis patients, facility staff, and other interested parties
Result
Our reports and dashboards provide CMS with important visibility into the latest changes in health outcomes and barriers to care for patients with ESRD. The in-depth analysis and data-driven conclusions identify program impacts on beneficiary groups, facilities, and providers and assess the distributional effects of the ESRD QIP to determine the program’s effectiveness in achieving the desired outcomes of CMS rulemaking. These results inform recommendations for CMS to continue to improve the management and operations of ESRD QIP.
Focus Areas
Health Services Research and Health Policy Quality MeasurementCapabilities
Analysis and Modeling Evaluation and Mixed-Methods ResearchSenior Expert Contact
Sonya Streeter
Associate Vice President
-
Expert Interview
Can an Open-Source Platform Transform Public Health Reporting and Modernize Medicine?June 2025
Healthcare providers and facilities in the U.S. are required by law to report many infectious disease cases as they occur for the public’s protection, but…
-
Expert Interview
Applying Infectious Disease Research Infrastructure to Chronic Disease PreventionJune 2025
Westat has coordinated a nationwide virtual research network of healthcare systems and research organizations that delivers relevant patient data to support research on respiratory disease…
-
Expert Interview
Improving Student Success Through Innovation and ResearchJune 2025
How do you turn innovative ideas into real, measurable improvements for students? One of the major tools available to support these efforts is the Education…