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Technical Specifications for ESRD QIP Measures

From 2010 to 2014, Arbor Research Collaborative for Health, in collaboration with the University of Michigan Kidney and Epidemiology Cost Center (UM-KECC), developed, maintained, and updated the ESRD QIP quality measures for CMS under the Quality Measure Development and Maintenance contract with CMS. These included the Clinical Performance Measures (CPM), the Dialysis Facility Compare (DFC) Measures, and the development of new quality measures.

New measures, as well as those that are revised, go through the National Quality Forum (NQF) consensus endorsement process. Once measures are in use, CMS requires that they periodically be reevaluated. This is to determine, for example, whether revisions are necessary in response to new clinical evidence or a change in clinical guidelines since the last cycle of review.

Beginning with the proposed rule for Payment Year 2017 and 2018, CMS will develop, maintain, and update the ESRD QIP quality measures. In addition, the technical specifications for prior proposed and final rules can be found in the following list.

(Note: Prior to PY 2015, the publication of stand-alone technical specifications as part of the rulemaking process was limited to clinical measures; therefore, technical specifications for the reporting measures in PY 2014 are not available. Further, specifications for the PY 2012 measures were not published in a stand-alone format; that content was included in the Guide to the 2010 Dialysis Facility Reports: Overview, Methodology, and Interpretation, published by Arbor Research. Likewise, because the two measures used in PY 2013 were continuations of PY 2012 measures, no stand-alone PY 2013 technical specifications were published as part of the rulemaking process.)

Please take note that the rulemaking process refers to calendar years (CY) for the ESRD Prospective Payment System (PPS), of which ESRD QIP regulations are a part. ESRD QIP Payment Years refer to the year in which a payment reduction would apply as a result of facility performance, whereas ESRD PPS Calendar Years refer to the year in which PPS payment policies take effect. In addition, an ESRD PPS CY rule often covers more than one ESRD QIP PY. For example, the CY 2012 ESRD PPS final rule established ESRD QIP PY 2013 and PY 2014; and the CY 2015 ESRD PPS final rule established ESRD QIP PY 2017 and PY 2018 (for more information, see the Laws & Regulations page). 


Current Technical Specifications of Record

The following files contain the most recent finalized technical specifications for the ESRD QIP.

CY 2018 ESRD PPS Final Rule

The CY 2018 ESRD PPS proposed rule was posted by CMS on November 1, 2017. It finalized:

  • Clinical and reporting measures for the PY 2021 ESRD QIP;
  • Modifications to PY 2019 and PY 2020 ESRD QIP; and
  • Programmatic changes.

Analyses Supporting the CY 2018 ESRD PPS Final Rule

The CY 2018 ESRD PPS final rule referenced the following analyses supporting the ESRD QIP policies made by CMS.

CY 2018 ESRD PPS Proposed Rule

The CY 2018 ESRD PPS proposed rule was posted by CMS on June 29, 2017. It proposed:

  • Clinical and reporting measures for the PY 2021 ESRD QIP;
  • Modifications to PY 2019 and PY 2020 ESRD QIP; and
  • Programmatic changes.
Proposed Measure Specifications for the PY 2021 ESRD QIP

The CY 2018 ESRD PPS proposed rule for PY 2021 included revised clinical measures for Vascular Access Type measure topic and Standardized Transfusion Ratio.

Analyses Supporting the CY 2018 ESRD PPS Proposed Rule

The CY 2018 ESRD PPS proposed rule referenced the following analyses supporting the ESRD QIP proposals made by CMS.


CY 2017 ESRD PPS Final Rule 

The CY 2017 ESRD PPS final rule was posted by CMS on October 28, 2016.

Final Measure Specifications for the PY 2020 ESRD QIP

This final rule containing measures for Payment Year 2020 was posted by CMS on October 28, 2016.

Final Measure Specifications for the PY 2019 ESRD QIP

This final rule containing revised measures for Payment Year 2019 was posted by CMS on October 28, 2016.

Final Measure Specifications for the PY 2018 ESRD QIP

This final rule containing revised measures for Payment Year 2018 was posted by CMS on October 28, 2016.

Analysis Supporting the CY 2017 ESRD PPS Final Rule

The CY 2017 ESRD PPS final rule referenced the following analysis supporting the ESRD QIP policies made by CMS.


CY 2017 ESRD PPS Proposed Rule

The CY 2017 ESRD PPS proposed rule was posted by CMS on June 24, 2016. It proposed:

  • Clinical and reporting measures for the PY 2020 ESRD QIP;
  • Modifications to PY 2019 and PY 2018 ESRD QIP; and
  • Programmatic changes.

Proposed Measure Specifications for the PY 2020 ESRD QIP 

The CY 2017 ESRD PPS proposed rule for PY 2020 included adding a Standardized Hospitalization Ratio (SHR) clinical measure and an Ultrafiltration Rate reporting measure, as well as replacing the prior Mineral Metabolism reporting measure with a Serum Phosphorus reporting measure.

Proposed Measure Specification for the PY 2019 ESRD QIP 

The CY 2017 ESRD PPS proposed rule included reintroducing the NHSN Dialysis Event reporting measure.

Proposed Measure Specification for the PY 2018 ESRD QIP

The CY 2017 ESRD PPS proposed rule included revising the previously finalized Hypercalcemia clinical measure.

Analyses Supporting the CY 2017 ESRD PPS Proposed Rule

The CY 2017 ESRD PPS proposed rule referenced the following analyses supporting the ESRD QIP proposals made by CMS.


CY 2016 ESRD PPS Final Rule

The CY 2016 ESRD PPS final rule was posted by CMS on October 30, 2015.

Final Measure Specifications for the PY 2019 ESRD QIP

This final rule containing measures for Payment Year 2019 was posted by CMS on October 30, 2015.

Final Measure Specifications for the PY 2018 ESRD QIP

This final rule containing measures for Payment Year 2018 was posted by CMS on October 30, 2015.

Final Measure Specifications for the PY 2017 ESRD QIP

This final rule containing proposed measures for Payment Year 2017 was posted by CMS on October 30, 2015.


CY 2016 ESRD PPS Proposed Rule

The CY 2016 ESRD PPS proposed rule was posted by CMS on June 26, 2015. It proposed:

  • Clinical and reporting measures for the PY 2019 ESRD QIP;
  • Modifications to PY 2018 and PY 2017 ESRD QIP; and
  • Programmatic changes.

Proposed Measure Specifications for the PY 2019 ESRD QIP 

The CY 2016 ESRD PPS proposed rule included a comprehensive Kt/V Dialysis Adequacy rule that consolidates the four individual measures finalized in earlier Payment Years.

Analyses Supporting the CY 2016 ESRD PPS Proposed Rule

The CY 2016 ESRD QIP proposed rule referenced the following analyses supporting the proposals made by CMS.

Proposed Measure Specifications for the PY 2018 ESRD QIP

The CY 2016 ESRD PPS proposed rule included minor text edits to the measure specifications for Payment Year 2018 ESRD QIP to improve documentation consistency; it also proposing a scoring modification for the Pain Assessment and Follow-Up reporting measure.

Proposed Measure Specifications for the PY 2017 ESRD QIP

The CY 2016 ESRD PPS proposed rule included minor text edits to the measure specifications for Payment Year 2017 ESRD QIP to improve documentation consistency; it also proposes to reinstate the CROWNWeb-based attestations regarding qualifying patients for the In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems reporting measure.


CY 2015 ESRD PPS Final Rule

The CY 2015 ESRD PPS final rule was posted by CMS on October 31, 2014.

Final Measure Specifications for the PY 2018 ESRD QIP

This final rule containing measures for Payment Year 2018 was posted by CMS on October 31, 2014.

Final Measure Specifications for the PY 2017 ESRD QIP

This final rule containing proposed measures for Payment Year 2017 was posted by CMS on October 31, 2014.


CY 2015 ESRD PPS Proposed Rule

The CY 2015 ESRD PPS proposed rule was posted by CMS on July 2, 2014. It proposed:

  • Clinical and reporting measures for the PY 2018 and PY 2017 ESRD QIP
  • Modifications to the NHSN Bloodstream Infection clinical measure for PY 2016; and
  • Programmatic changes. 

Proposed Measure Specifications for the PY 2018 ESRD QIP

This proposed rule containing proposed measures for Payment Year 2018 was posted by CMS on July 2, 2014.

Proposed Measure Specifications for the PY 2017 ESRD QIP

This proposed rule containing proposed measures for Payment Year 2017 was posted by CMS on July 2, 2014.

 Proposed Measure Modification for the PY 2016 ESRD QIP

The PY 2017 – PY 2018 proposed rule posted by CMS on July 2, 2014, included a proposed modification for the NHSN Bloodstream Infections in Hemodialysis Outpatients clinical measure for Payment Year 2016.

Analyses Supporting CY 2015 ESRD PPS Proposed Rule

The PY 2017 – PY 2018 ESRD QIP proposed rule posted by CMS on July 2, 2014, referenced the following analyses supporting the proposals made by CMS.


CY 2014 ESRD PPS Final Rule

The CY 2014 ESRD PPS final rule was displayed by CMS on November 22, 2013.

Final Measure Specifications for the PY 2016 ESRD QIP

This final rule containing measures for Payment Year 2016 was displayed by CMS on November 22, 2013.


CY 2014 ESRD PPS Proposed Rule

The CY 2014 ESRD PPS proposed rule was posted by CMS on July 1, 2013. It proposed clinical and reporting measures for the PY 2016 ESRD QIP.

Proposed Measure Specifications for the PY 2016 ESRD QIP

This proposed rule containing proposed measures for Payment Year 2016 was posted by CMS on July 1, 2013.


CY 2013 ESRD PPS Final Rule

The CY 2013 ESRD PPS final rule was published by CMS on November 2, 2012.

Final Measure Specifications for the PY 2015 ESRD QIP

This final rule containing measures for Payment Year 2015 was published by CMS on November 2, 2012.


CY 2013 ESRD PPS Proposed Rule

The CY 2013 ESRD PPS proposed rule was posted by CMS on July 2, 2012. It proposed clinical and reporting measures for the PY 2015 ESRD QIP.

Proposed Measure Specifications for the PY 2015 ESRD QIP

This proposed rule containing proposed measures for Payment Year 2015 was posted by CMS on July 2, 2012.


CY 2012 ESRD PPS Final Rule

The CY 2012 ESRD PPS final rule was published by CMS on November 1, 2011.

PY 2014 ESRD QIP Performance Standards

Performance standards for Payment Year 2014 are calculated using data collected over a full year (July 1, 2010 through June 30, 2011) in accordance with the Final Rule published by CMS on November 1, 2011.

Final Clinical Measure Specifications for the PY 2014 ESRD QIP

This final rule containing measures for Payment Year 2014 was published by CMS on November 1, 2011.

Final Measure Specifications for the PY 2013 ESRD QIP

This final rule containing measures for Payment Year 2013 was published by CMS on November 1, 2011.


CY 2012 ESRD PPS Proposed Rule

The CY 2012 ESRD PPS proposed rule was posted by CMS on July 1, 2011. It proposed clinical and reporting measures for the PY 2014 ESRD QIP, as well as measures for the PY 2013 ESRD QIP.

Proposed Clinical Measure Specifications for the PY 2014 ESRD QIP

This proposed rule containing measures for Payment Year 2014 was published by CMS on July 1, 2011.

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