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Kidney Week

Abstract: PO1048

Comparison of ESRD Quality Incentive Program (QIP) Performance and Dialysis Facility Compare (DFC) Star Rating

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Kapke, Alissa, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Ding, Zhechen, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Dahlerus, Claudia, Nephrology Division, Michigan Medicine, Ann Arbor, Michigan, United States
  • Messana, J. M., Nephrology Division, Michigan Medicine, Ann Arbor, Michigan, United States
  • Houseal, Delia, Centers for Medicare and Medicaid Services, Baltimore, Maryland, United States
  • Roach, Jesse, Centers for Medicare and Medicaid Services, Baltimore, Maryland, United States
  • Turenne, Marc, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
Background

The DFC quality of patient care star rating system reached its 5-year mark in 2020 and the ESRD QIP surpassed its 10-year mark. Both programs have undergone considerable changes in a continuing effort to help patients make informed decisions when selecting a provider while also incentivizing high quality care. We assessed whether ESRD QIP scores and payment reductions aligned with facilities’ star ratings in calendar year (CY) 2018.

Methods

Payment year (PY) 2020 QIP scores and payment reductions (PR) and CY 2018 star ratings (1-5 stars) were obtained from DFC public data files. Comparisons between the two programs were assessed with cross-tabulations of PR categories and star ratings and with t-tests comparing mean QIP Total Performance Scores (TPS) among adjacent PR and star rating levels.

Results

Facilities with higher PY 2020 QIP scores tended to receive higher star ratings. Among facilities with no PR (N=3,929), 79.4% received 4 or 5-stars and 91.7% of facilities with a 2% PR received 1 or 2-stars. The average facility TPS decreased by approximately 10 points with each decrease in star rating, with significant differences between all categories (Table 1).

Conclusion

The ESRD QIP and the star rating program have distinct goals which have led to differences in their design and methodology, such as the use of the small facility adjuster in the ESRD QIP and non-overlapping measures between the two programs. Nevertheless, there is strong overall correspondence between the two programs in their assessments of facility quality of care. These results are reassuring, in that QIP scores and star ratings are providing a consistent message about dialysis facility quality of care in most cases.

Funding

  • Other U.S. Government Support