ESRD providers to receive pay boost in 2023
Dialysis providers will receive a 3.1% pay increase from the Centers for Medicare and Medicaid Services in 2023, the agency announced in a final rule issued Monday.
CMS will hike the base rate paid for dialysis services by $7.67 to $265.57. Hospital-based end-stage renal disease providers will receive an estimated 3.1% increase in payments and freestanding facilities will receive 3%, according to CMS. Come 2023, the agency will also permanently bar ESRD facilities from decreasing workers’ wages by more than 5% annually, regardless of the circumstances causing the decline, according to the rule.
The agency will suppress seven metrics from its quality improvement plan next year to account for the effects of COVID-19, including a readmission ratio and the in-center hemodialysis consumer experience survey. CMS will collect and post the data but not factor them into payments. Officials will rely on 2019 data for these measures to assess providers’ quality.
Beginning in 2025, CMS will also factor in healthcare employees’ COVID-19 vaccination status when assessing facilities’ quality. Providers must begin reporting that information in 2023.
CMS additionally finalized a plan to convert the standardized transfusion ratio reporting measure, which tracks how many red blood cell transfusions a facility performs relative to the national average, into a clinical metric starting in 2025.
The clinical measure for hypercalcemia — when calcium levels in the blood are too high — will be converted to a reporting measure in 2025. CMS will work on identifying replacement metrics that more accurately reflect quality improvement.
CMS also updated the scoring methodology and clarified the patient education services requirements for the ESRD Treatment Choices Model. The mandatory Center for Medicare and Medicaid Innovation payment initiative began in January 2021 and runs through June 2027.
CMS modified the model last year to create incentives for providers to reduce disparities in home dialysis and kidney transplant rates. The agency does not anticipate the final rule’s changes to influence the net savings of the model, which are expected to reach $28 million over its 6.5-year lifespan.
The agency denied payment adjusters for three new dialysis-related products.