The ESRD Network Coordinating Center (NCC) provides centralized coordination and support for the Medicare ESRD Network Program.

What Is the ESRD Network Program?

The ESRD Network program began in 1977 when the Department of Health and Human Services (formerly Department of Health, Education and Welfare) published the final regulations establishing 32 Network Coordinating Councils to administer the newly funded program. With only 40,000 dialysis patients receiving care in 600 facilities, the Networks' responsibilities focused on organizational activities, health planning tasks, and medical review activities.

By December 31, 1987, the ESRD program encompassed 98,432 patients and 1,701 facilities administering renal replacement therapy. At this time, Congress consolidated the 32 Networks into 18, redistributing and increasing their geographical areas as well as their program responsibilities. Funding mechanisms changed when Congress mandated that $ 0.50 from the composite rate payment from each dialysis treatment be withheld and allocated to fund the ESRD Network program. In 1988 CMS began formal contracting with the ESRD Networks to meet their legislative responsibilities. These contracts placed greater emphasis on quality improvement activities and standardized approaches to quality assessment and data analysis; health-planning functions were reduced.

In 2002, the ESRD program encompassed 299,591 patients and 4,443 providers. The Networks now operate on a three-year Statement of Work (SOW) cycle. The 2003 - 2006 SOW was implemented in July 2003. At the time of the contract renewal, CMS provided an updated ESRD Network Organization Manual that provided background and articulated responsibilities of the Networks as well as modifications to some requirements of the ESRD Network program. This manual further describes contract responsibilities.

As specified in the Statement of Work, each Network is responsible for conducting activities in the following areas:

  1. Quality Improvement
  2. Community Information and Resources
  3. Administration
  4. Information Management
  5. Special Studies

CMS contracts require each Network to have an Executive Director, a Director of Quality Improvement, and a Director of Data Management as well as other necessary staff to fulfill the contract obligations. The role of the Executive Director is to coordinate the activities of the Network. The Director of Quality Improvement coordinates quality-related requirements and creates and implements quality improvement projects. The role of the Director of Data Management is the accurate recording and transmission of data between the facilities, the Network, and CMS.

In addition to these staff members, Networks employ other individuals to accomplish contract responsibilities. Though these positions vary from Network to Network, additional staff in the areas of quality improvement, data, and patient services are essential for the coordination of the many Network activities.


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