ESRD Quality Incentive Program
Guidance for describing the ESRD Quality Incentive Program, recent updates and links to more information.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: May 06, 2020
The Centers for Medicare & Medicaid Services (CMS) administers the End-Stage Renal Disease Quality Incentive Program (ESRD QIP) to promote high-quality services in renal dialysis facilities. The first of its kind in Medicare, this program changes the way CMS pays for the treatment of patients who receive dialysis by linking a portion of payment directly to facilities’ performance on quality of care measures. These types of programs are known as “pay-for-performance” or “value-based purchasing” (VBP) programs.
CMS publicly reports facility ESRD QIP scores and payment adjustments on Care Compare on the Medicare.gov website. In addition, each facility is required to display a Performance Score Certificate (PSC) that lists its Total Performance Score (TPS), for that payment year.
How does the ESRD QIP work?
The ESRD QIP reduces payments to renal dialysis facilities that do not meet or exceed certain performance standards on applicable measures. The maximum payment reduction CMS can apply to any facility is two percent. This reduction applies to all payments for services performed by the facility receiving the reduction during the applicable payment year (PY).
The ESRD QIP scores facilities on their performance according to the measures established for the relevant payment year. For clinical measures, CMS applies two scoring methods: achievement (comparing facility performance to a set of values derived from all facilities nationally) and improvement (comparing facility performance to the facility's individual performance during the prior year). For reporting measures, CMS assigns points based on whether a facility provided the required data.
The latest ESRD QIP update
Performance Score Reports (PSRs) for PY 2025 were provided to each dialysis facility on November 6, 2024. The PSR gives facilities their measure rates, TPS, and total payment reduction for PY 2025.
CMS will publicly report the facility scores from PY 2025 in the Provider Data Catalog in April 2025.
On November 12, 2024, CMS published the Calendar Year (CY) 2025 End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) Final Rule which contains ESRD QIP policies covering PY 2027. See the Laws & Regulations page for more information regarding the ESRD QIP rules.
More information
For more information regarding the ESRD QIP Program, refer to the ESRD QIP page located at QualityNet.cms.gov and the frequently asked questions available in the ESRD QIP Question and Answer (Q&A) tool. Additional questions can be submitted in the Q&A tool by selecting ‘Ask a Question’.
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