Early winners and losers in dialysis center pay-for-performance

BMC Health Serv Res. 2017 Dec 8;17(1):816. doi: 10.1186/s12913-017-2764-4.

Abstract

Background: We examined the association of dialysis facility characteristics with payment reductions and change in clinical performance measures during the first year of the United States Centers for Medicare & Medicaid Services (CMS) End Stage Renal Disease Quality Incentive Plan (ESRD QIP) to determine its potential impact on quality and disparities in dialysis care.

Methods: We linked the 2012 ESRD QIP Facility Performance File to the 2007-2011 American Community Survey by zip code and dichotomized the QIP total performance scores-derived from percent of patients with urea reduction rate > 65, hemoglobin < 10 g/dL, and hemoglobin > 12 g/dL-as 'any' versus 'no' payment reduction. We characterized associations between payment reduction and dialysis facility characteristics and neighborhood demographics, and examined changes in facility outcomes between 2007 and 2010.

Results: In multivariable analysis, facilities with any payment reduction were more likely to have longer operation (OR 1.03 per year), a medium or large number of stations (OR 1.31 and OR 1.42, respectively), and a larger proportion of African Americans (OR 1.25, highest versus lowest quartile), all p < 0.05. Most improvement in clinical performance was due to reduced overtreatment of anemia, a decline in the percentage of patients with hemoglobin ≥ 12 g/dL; for-profits and facilities in African American neighborhoods had the greatest reduction.

Conclusions: In the first year of CMS pay-for-performance, most clinical improvement was due to reduced overtreatment of anemia. Facilities in African American neighborhoods were more likely to receive a payment reduction, despite their large decline in anemia overtreatment.

Keywords: End stage renal disease; Pay-for-performance; Quality improvement; Racial disparities.

MeSH terms

  • Ambulatory Care Facilities / economics
  • Ambulatory Care Facilities / standards
  • Black or African American
  • Centers for Medicare and Medicaid Services, U.S.
  • Health Facilities
  • Healthcare Disparities / economics*
  • Healthcare Disparities / ethnology
  • Humans
  • Kidney Failure, Chronic / ethnology
  • Kidney Failure, Chronic / therapy*
  • Multivariate Analysis
  • Quality Improvement / economics*
  • Quality of Health Care
  • Reimbursement, Incentive*
  • Renal Dialysis / economics*
  • Renal Dialysis / standards
  • Residence Characteristics
  • United States