Did you know?
ü The IPRO ESRD Network of New York (Network 2), under contract with the Centers for Medicare & Medicaid Services, is charged with working with dialysis facilities in New York State to increase the number of patients using AV Fistulas (AVF) and to decrease the number of patients using Long-Term Catheters (LTC). (A patient that has used a catheter for 90 days or more is considered to have a long-term catheter.)
ü CMS has established long term or "stretch" goals for the nation and for each individual Network. The Network goals are calculated using September 2014 data as the baseline and September 2015 data for the re-measure.
|
AVF rates |
LTC Rates |
|
CMS' Goals |
|
68% |
<10% |
|
Network 2's Goals |
|
66.59% |
10.38% |
ü How your facility's vascular access rates compare to national rates and to Network 2 rates? It is important to know how you are doing compared to others. The data below show the baseline data, September 2014, for the above goals.
|
AVF |
AVG |
CVC* w/maturing AVF |
CVC w/maturing AVG |
STC** |
LTC |
|
National Rates |
|
63.08% |
18.14% |
17.3% |
6.95% |
6.29% |
10.73% |
|
Network Rates |
|
65.59% |
14.52% |
15.07% |
40.35% |
6.2% |
12.38% |
*CVC = Central Venous Catheter
** STC = Short Term Catheter (in use for less than 90 days)
ü The performance of facilities in our Network. There are 253 hemodialysis facilities in New York State that are reporting vascular access data in CROWNWeb. Many of these facilities are either meeting or exceeding the goals of both the Network and CMS.
|
|
# of facilities meeting goal |
% of facilities meeting goal |
|
AVF rate > 68%* |
103 |
40.71% |
|
AVF rates meeting QIP achievement score - 10 points** |
44 |
17.12% |
|
LTC rates < 10%* |
97 |
38.34% |
|
LTC rates meeting QIP achievement score - 10 points** |
25 |
9.27% |
*As of September 2014
** Payment year 2015
The Quality Incentive Program for payment year 2017 is based on your facility's performance in 2015. If your facility does not meet the performance goals established by CMS, reimbursements to your facility may be decreased as much as 2%.
o The Quality Incentive Program includes eight clinical measures and three reporting measures.
o One of the clinical measures is for AVF rates and another measure is for LTC rates.
o For each measure your facility can earn up to 10 points.
o There are two ways to accrue points for the clinical measure: the, achievement score or the improvement score.
o The achievement score is calculated by comparing the facility's performance in 2015 to its performance in 2013 (the comparison period),
o The improvement score is determined by comparing the facility's performance in 2015 with its previous comparison year, 2014.
|
Measure |
Achievement Threshold (15 percentile) |
Between Achievement and Benchmark |
Benchmark
(90 percentile) |
|
|
0 points |
1-9 points |
10 points if greater than or equal to |
|
Achievement Score |
|
AVF |
< 52.42% |
52.42%-78.56% |
>78.56% |
|
LTC |
>18.36% |
18.36%-3.23% |
<3.23% |
|
Improvement Score |
|
AVF |
<Performance Year 2014 |
Performance Year 2014 - 78.56% |
>78.56% |
|
LTC |
> Performance Year 2014 |
Performance Year 2014 - 3.23% |
<3.23% |
One of the first steps in quality improvement is to assess your performance and to identify areas that need to be improved. By comparing your performance to the other facilities in New York State and across the nation, you will be able to determine whether your facility is meeting clinical standards or if facility staff need to devote time to identifying barriers and ways to overcome these barriers.
The information and data provided in this article are intended to help you to determine where your facility stands in meeting the vascular access goals set by CMS and the Network.
