Dialysis services would receive $50 million in additional Medicare reimbursements under a 0.5 percent increase included in suggested rate changes by CMS.

The changes were proposed as part of broader update of the payment policies and rule for Medicare’s End-Stage Renal Disease (ESRD) Prospective Payment System, along with adjusting quality measures for dialysis facilities.

“The ESRD PPS proposed rule is one of several rules for calendar year 2017 that reflect a broader Administration-wide strategy to deliver better care at lower cost by finding better ways to deliver care, pay providers, and use information,” CMS said in a press release. “Provisions in these rules are helping to move our health care system to one that values quality over quantity and focuses on achieving better health outcomes, preventing disease, helping patients live successfully at home, helping manage and improve chronic diseases, and fostering a more efficient and coordinated health care system.”

The changes which would take effect January 1, 2017, include:

• Raising the bundled payment rate for 2017 by $0.65 to $231.04.
• No change to the wage index floor for 2017.
• Updating the outlier policy.
• A $45 increase to cover extra training for registered nurses for peritoneal dialysis (PD) and hemodialysis (HD).

On quality measures, CMS has some adjustments in some areas and brand new measures in others. For the clinical measure on hypercalcemia, the agency said “two substantive changes” are needed.

“These changes involve updating the measure’s technical specifications for 2018 and future years to include plasma as an acceptable substrate in addition to serum calcium, as well as changing the denominator definition to include patient-months in the denominator even in the event that a facility reported no calcium values during the three-month study period,” CMS said.

Those changes would go into effect in the 2018 payment year.

For fiscal year 2019, CMS has suggested adding a new “Safety Measure Domain” as a third measure category, which would account for 15 percent of a facility’s performance score for that payment year.