The ESRD quality incentive program measures the quality of care received at dialysis centers by Medicare ESRD patients. There are a total of 16 measures: 11 clinical and 5 reporting, and they are detailed here:
- NHSN bloodstream infection in hemodialysis outpatients: Infections may occur from hemodialysis when the improper sterilization technique is used. This measure examines the number of infections that occur (the numerator) and compares it to the expected amount (the denominator).
- ICH CAHPS: This measure examines the quality of care received at the dialysis center through assessment of patient survey responses.
- Standardized readmission ratio: The standardized readmission ratio is the number of actual unplanned 30-day readmissions divided by the expected unplanned 30-day readmissions.
- Kt/V dialysis adequacy measure – hemodialysis: Kt/V is a formula that quantifies the dialysis treatment adequacy. The four Kt/V measures examine how many treatment sessions met a certain Kt/V threshold for different dialysis patient populations:
- Kt/V dialysis adequacy measure – Peritoneal dialysis
- Kt/V dialysis adequacy measure – Pediatric hemodialysis
- Kt/V dialysis adequacy measure – Pediatric peritoneal dialysis
- Standardized transfusion ratio: This measure compares the number of actual versus expected red blood cell transfusions in dialysis patients (blood transfusions are undesirable consequences of dialysis).
- Vascular access – Fistula: The vascular access measures quantify whether or not proper access was provided to the patient's bloodstream. The Fistula measure evaluates how many arteriovenous fistula sites used two needles for access.
- Vascular access – Catheter - The Catheter measure determines how many of the catheters have been present in the patient for more than 90 days, which is an infection risk.
- Hypercalcemia: This measure looks at how many months for which patients experienced hypercalcemia, an adverse effect of dialysis.
- Mineral metabolism reporting: The five reporting measures examine how well various aspects of the dialysis patient's care were reported by each facility. The measures examine mineral metabolism reporting, anemia management reporting, pain assessment, depression screening, and flu vaccine for personnel reporting:
- Anemia management reporting
- Pain assessment and follow-up reporting
- Clinical depression screening and follow-up reporting
- Flu vaccine for personnel reporting