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Federal Register / Vol. 86, No. 129 / Friday, July 9, 2021 / Proposed Rules
were required to have at least one measure in at least two domains to receive a TPS.
To estimate the total payment reductions in PY 2024 for each facility resulting from this final rule, we multiplied the total Medicare payments to the facility during the 1-year period between January 2019 and December 2019 by the facilitys estimated payment reduction percentage expected under
the ESRD QIP, yielding a total payment reduction amount for each facility.
Table 13 shows the estimated impact of the finalized ESRD QIP payment reductions to all ESRD facilities for PY
2024. The table also details the distribution of ESRD facilities by size both among facilities considered to be small entities and by number of treatments per facility, geography both rural and urban and by region, and
facility type hospital based and freestanding facilities. Given that the performance period used for these calculations differs from the performance period we are using for the PY 2024 ESRD QIP, the actual impact of the PY 2024 ESRD QIP may vary significantly from the values provided here.

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Number of Facilities 7,610
7,224

Number of Treatments 2019 in millions 44.8
43.1

Number of Facilities with QIP
Score 7,369
7,024

Number of Facilities Expected to Receive a Payment Reduction 1,799
1,691

Payment Reduction percent change in total ESRD
payments -0.16%
-0.15%

345
5,686

108
1,200

-0.26%
-0.12%

921
491
264
7 6,607

268
240
89
2 1,468

-0.20%
-0.38%
-0.29%
-0.21%
-0.13%

755
7 1,237

329
2 203

-0.35%
-0.21%
-0.09%

6,132
1,000

1,596
261

-0.17%
-0.16%

1,663
3,364
1,283
59
8

431
909
165
33
4

-0.18%
-0.17%
-0.08%
-0.36%
-0.37%

1,171
592
806
405
194
878
1,700
492
1,072
51
1,195

355
135
227
52
34
113
494
76
280
29
265

-0.21%
-0.13%
-0.17%
-0.08%
-0.10%
-0.08%
-0.19%
-0.10%
-0.17%
-0.36%
-0.17%

2,771
3,240
163

555
947
32

-0.13%
-0.17%
-0.18%

All Facilities Facility Type:
Freestanding Hospital-based 386
1.8
Ownership Type:
5,809
34.8
Large Dialysis Regional Chain 944
5.7
Independent 534
2.9
Hospital-based non-chain 299
1.3
Unknown 24
0.0
Facility Size:
6,753
40.6
Large Entities Small Entities 1
833
4.3
Unknown 24
0.0
Rural Status:
1,292
6.5
I Yes 2No 6,318
38.4
Census Region:
1,046
6.7
Northeast Midwest 1,734
8.3
South 3,452
20.6
West 1,318
8.7
60
0.4
US Territories 2
Census Division:
8 0.1
Unknown East North Central 1,220
6.0
East South Central 604
3.3
Middle Atlantic 845
5.4
Mountain 419
2.4
New England 201
1.4
Pacific 899
6.3
South Atlantic 1,746
10.7
West North Central 514
2.3
West South Central 1,102
6.7
US Territories 2
52
0.3
1,315
2.6
Facility Size oftotal treatments Less than 4,000 treatments 4, 000-9 ,999 treatments 2,803
12.2
Over 10,000 treatments 3,246
29.7
Unknown 246
0.3
1Small Entities include hospital-based and satellite facilities, and non-chain facilities based on DFC self-reported status.
2Includes American Samoa, Guam, Northern Mariana Islands, Puerto Rico, and Virgin Islands.

c. Effects of the PY 2025 ESRD QIP on ESRD Facilities For the PY 2025 ESRD QIP, we estimate that, of the 7,610 dialysis
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facilities including those not receiving a TPS enrolled in Medicare, approximately 24.4 percent or 1,799 of the facilities that have sufficient data to
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calculate a TPS would receive a payment reduction for PY 2025. The total payment reductions for all the 1,799 facilities expected to receive a
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09JYP2

EP09JY21.014

TABLE 13: Estimated Impact of QIP Payment Reductions to ESRD Facilities for PY 2024