Dialysis business may get funneled away from nursing homes.

The Centers for Medicare & Medicaid Services has proposed a rule that would create a pay-for-performance system for end-stage renal disease facilities.

CMS’s proposed quality incentive program (QIP) links a facility’s payments to performance standards, according to a CMS press release. It would be the first pay-for-performance program in a Medicare fee-for-service payment system. The agency also issued a separate final rule that allows the agency to pay dialysis facilities a single bundled rate for renal dialysis services and home dialysis, with a payment adjustment for home dialysis training when clinically appropriate. The providers that are the subject to the rules offer dialysis to Medicare recipients with end-stage renal disease.

The final rule sets a base payment rate of $229.63 for each dialysis treatment, which would be adjusted for case-mix factors including patient’s age, body size, and time on dialysis, according to CMS. The new payment system will take effect Jan 1, 2011. More information on the proposed rule and final rule is available in the Federal Register.