In a recent proposed rule, CMS asked for input on potential patient experience measures for the ESRD (End Stage Renal Disease) Treatment Choices (ETC) Model. This mandatory payment model seeks to encourage the use of home dialysis or kidney transplants to reduce costs associated with ESRD treatment while potentially improving the quality of care for patients.
This model currently uses two ESRD facility quality measures: Standardized Mortality Ratio (SMR) (NQF #0369) and Standardized Hospitalization Ratio (NQF #1463). These existing measures are already being collected from claims data and are currently publicly reported on Dialysis Facility Compare. CMS is exploring the inclusion of a patient experience measure for patients who receive dialysis at home or have had transplants. The current ICH CAHPS survey is only completed with patients who currently receive dialysis in-center, so it excludes patients who receive dialysis at home or have had transplants.
CMS seeks feedback on potential patient experience measures, including topics such as patient satisfaction, patient activation, and quality of life, and posed several questions they would like commenters to consider:
- What domains of a patient experience of care with home dialysis would be the most useful to assess and why?
- Would you prefer the measure to be newly developed or an update to an existing measure? If an update, which existing measure should be updated?
- How would a patient experience measure be best used to further the purpose of the ETC Model?
- How should CMS use a patient experience measure to assess the quality of care of beneficiaries?
- How should CMS use a patient experience measure to incentivize improved quality of care in the ETC Model and/or for other CMS programs?
If you have suggestions or feedback for CMS on potential dialysis patient experience measures, please submit them via http://www.regulations.gov by August 31, 2021.