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Reducing Catheter Rates

The Centers for Medicare and Medicaid established the National Access Improvement Initiative (NVAII) in 2003 which in 2005 became the Fistula First Breakthrough Initiative (FFBI). The FFBI transitioned to the Fistula First Catheter Last Workgroup Coalition (FFCL) in 2012 to focus on the development of tools and resources to help dialysis facilities and clinicians reduce catheters and increase AV fistula rates in hemodialysis patients. The Quality Incentive Program achievement threshold (15th percentile) for payment year 2019 (based on 2017 outcomes) is 17.20% for long-term catheters with a performance standard of 9.19% (median) and a benchmark (50th percentile) of 2.95%.

Our 2017 “Catheter Last” QIA is comprised of 73 facilities with long-term (catheter as only access for > 90 days) catheter (LTC) rates of > 15% in September 2016., rising to > than 15% by October 2016. We are also monitoring 95 additional facilities (tier two) with LTC rates > 10% but < 15% in September 2016. Tier two facilities with rising LTC rates are moved under closer monitoring and intervention if rates reach 15% for three consecutive months.

If you need assistance with catheter reduction improvement activities, please contact Sheila McMaster, Network 8 Quality Improvement Director to discuss (601-936-9260 or

Tools and Resources


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