NCQA (and its partners) March for Quality Care for Kidney Disease

March 23, 2015 · Michael S. Barr, MD

March is National Kidney Month. We can’t let it pass without mentioning the efforts by the Centers for Medicare & Medicaid (CMS) to improve the quality of care for people living with kidney disease, and the growing number who face kidney failure.

But first, some alarming facts from the National Kidney Foundation:

• One in 3 American adults is at risk for developing kidney disease.
• In 2013, more than 47,000 Americans died from kidney disease—our 9th leading cause of death.
• A growing number of Americans are diagnosed with kidney failure, which means they will need dialysis or a kidney transplant.
• Right now, 450,000 Americans are on dialysis.

That’s serious business.

Fortunately, CMS and its Innovation Center are battling this disease on one front, improving care for patients with end-stage renal disease (ESRD—also known as “kidney failure”). That’s a goal NCQA can get behind.

In fact, we are.

With our partners at IMPAQ International, we are supporting the CMS Comprehensive ESRD Care Initiative, which evaluates an accountable care model for kidney failure patients on dialysis.

You might know that accountable care organizations (ACO) are networks of providers—in this case, dialysis facilities, nephrologists and other specialists—that work together to coordinate patient care. The idea is to offer payment incentives for more efficient, higher-quality care. Our work with IMPAQ International will evaluate this initiative.

NCQA is part of a team that is responsible for developing the initiative’s quality strategy—selecting performance measures, adapting technical specifications, developing data collection and scoring methodologies. The networks will be evaluated on dialysis-related measures and on measures that address other facets of the complex care kidney failure patients receive, including quality-of-life care, hospitalizations and readmissions, and diabetes care.

Of course, NCQA has a background in guiding networks like these to success. We already include Medical Attention for Nephropathy (kidney disease) as a measure in our evaluation of comprehensive diabetes care. This performance measure is a part of the Healthcare Effectiveness Data and Information Set (HEDIS) that already 90 percent of America’s health plans use to measure.

We at NCQA are gratified to partner in these efforts to carry specialized network care a step farther. Especially this month. Especially when it is so clear that so many lives depend upon it.