Perpetuating sub-optimal care: CMS, QIPs, and the hemoglobin myth

As the new Centers for Medicare & Medicaid Services' Quality Incentive Program takes effect, the implications are enormous for dialysis patients. Contrary to its intention, the Quality Incentive Program, with its upper hemoglobin limit, may well stifle innovative practice-based research and practical approaches to anemia management. An opportunity to move away from an excessive preoccupation with ESAs to substantially improve patient outcomes, and to do so at a much lower cost, may well be lost to patients, providers, and CMS as a result.