Federal Register - November 8, 2021
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Fuente: Federal Register
Federal Register / Vol. 86, No. 213 / Monday, November 8, 2021 / Rules and Regulations were available data from EQRS and Medicare claims. Payment reduction estimates are calculated using the most
recent data available specified in Table 12 in accordance with the policies finalized in this final rule. Measures
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used for the simulation are shown in Table 12.
TABLE12 : Daa t Use dt0 E sf1mate PY2024ESRDQIPP aymentReducfions
ICH CARPS Survey SRR
SHR
PPPW
Kt/V Dialysis Adequacy Comprehensive VAT
Standardized Fistula Ratio % Catheter Hypercalcemia
lotter on DSK11XQN23PROD with RULES2
For all measures except the SHR
clinical measure, the Standardized Readmission Ratio SRR clinical measure, and the STrR reporting measure, measures with less than 11
patients for a facility were not included in that facilitys TPS. For the SHR
clinical measure and the SRR clinical measure, facilities were required to have at least 5 patient-years at risk and 11
index discharges, respectively, in order to be included in the facilitys TPS. For the STrR reporting measure, facilities were required to have at least 10
patient-years at risk in order to be included in the facilitys TPS. Each facilitys TPS was compared to an estimated mTPS and an estimated payment reduction table that were
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consistent with the finalized polices outlined in sections IV.E. and IV.F. of this final rule. Facility reporting measure scores were estimated using available data from CY 2019. Facilities 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.
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Performance period
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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Measure
Period of time used to calculate achievement thresholds, 50th percentiles of the national performance, benchmarks, and improvement thresholds Jan 2018-Dec 2018
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