February 20, 2017
Webinar Recording Now Available: 2017 Network Activities and CMS Expectations
In case you missed it, a recording of the "2017 Network Activities and CMS Expectations" webinar hosted by the Network on January 12, 2017 is now available on YouTube at

We encourage all facility staff to watch the recorded webinar to learn about the Centers for Medicare & Medicaid Services' (CMS) expectations for 2017 and what activities the Network has planned.  

The Network wants to hear from you about future educational opportunities. Please complete a quick assessment at  https://survey.constantcontact.com/survey/a07edudj30kiza0fkr7/start                                                                                                                                                                                                  
CMS - Engaging Multiple Payers in Payment Reform
The Affordable Care Act created the Center for Medicare & Medicaid Innovation (CMS Innovation Center) to test new payment and service delivery models aimed at reducing program expenditures under Medicare, Medicaid, and the Children's Health Insurance Program (CHIP) and to enhance the quality of care that CMS beneficiaries receive.  The Innovation Center is testing more than 20 models that create new incentives for clinicians and organizations that deliver medical care through CMS programs, with a goal to deliver better care at lower cost.  CMS is also supporting a variety of state efforts to create new incentives for these clinicians and organizations through the Medicaid and CHIP programs.  All of these models share a common pathway for success:  They hinge on getting clinicians and healthcare organizations to manage the health of populations and to act as good stewards of healthcare resources.
To read the full article in JAMA, click here.

For the supplemental readings, click here.
Patient Services
February is American Heart Month!
Heart disease is the leading cause of death for American women and men, accounting for 1 in 4 deaths in the United States. Nearly half of Americans have at least one risk factor for heart disease, such as high blood pressure, obesity, physical inactivity, or an unhealthy diet. Risk also increases with age.

7 Simple Tips to Get an Accurate Blood Pressure Reading  

It's easy to get skewed results if clinicians and patients aren't on the same page about how to take accurate blood pressure measurements. 

This infographic from the American Medical Association offers a simple way to help ensure the most accurate results.
Quality Improvement
Secondary Hyperparathyroidism in ESRD Patients
Many dialysis patients develop secondary hyperparathyroidism (SHPT) due to complications of their renal disease that cause complex alterations in bone and mineral metabolism.  Patients diagnosed with SHPT are at increased risk of developing hypercalcemia. 
Patients with hypercalcemia may experience the following symptoms and are at increased risk for cardiovascular disease, morbidity, and mortality:
  • Abdomen pain
  • Nausea/ vomiting
  • Constipation
  • Muscle twitching/ weakness
Dialysis providers continuously struggle to manage the calcium levels of patients with chronic kidney disease (CKD) and ESRD. Many patients struggle to adhere to a diet low in calcium and phosphate. Many of the binders prescribed to maintain patients' phosphorus levels are calcium-based binders. Patients who find the aluminum- magnesium based binders costly will often purchase over the counter antacids to replace their binders.
Patients with ESRD typically have lower amounts of vitamin D to help them metabolize calcium properly and may take over the counter vitamins to help boost  vitamin  D levels, while unknowingly increasing their calcium levels as well.
Mineral metabolism is an important consideration for the patient, and it is imperative for the clinic to monitor. The CMS Quality Incentive Program (QIP) uses mineral metabolism as one of its measurement to assess quality outcomes for patients. Depending on the percent of patients in a facility that have hypercalcemia, the facility may experience a reduction in payment from Medicare.

Data Management
CrownWeb and NHSN Data Validation Project in the Payment Year 2017 Final Rule
Allegheny Science & Technology (AST) is under contract with CMS to validate the accuracy of CROWNWeb and NHSN data.  AST has a data use agreement in place with CMS to request and receive patient records from dialysis facilities for this purpose. 
CMS describes this validation project in the PY2017 final rule, which can be accessed at the following link:


Dialysis Event Surveillance Training
At least one staff member at every dialysis facility must  complete Dialysis Event Surveillance protocol training for the National Healthcare Safety Network (NHSN) on an annual basis. Please complete the training as soon as possible.  

The Network will track each facility's completion of the training and will contact leadership at those facilities that do not complete  this CDC requirement.

If you have any questions, please contact Krystle Gonzalez, Sr. Data Coordinator.
Use the Network Data Knowledge Base and Customer Portal
With the increase in data that must be submitted, as well as systems through which the data is collected, there are multiple ways in which you can reach the Network Data Support Team for help. 
*Please remember that you should NEVER include any patient-specific information such as Name, Date of Birth, Social Security Number, Medicare Claim Number, etc. The only patient identifier that can safely be communicated is the Unique Patient Identifier (UPI) from CROWNWeb.*

IPRO End-Stage Renal Disease Network of New England, the ESRD Organization for Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont, prepared this material under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. CMS Contract Number: HHSM-500-2016-00019C.