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Federal Register / Vol. 86, No. 213 / Monday, November 8, 2021 / Rules and Regulations
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TABLE 14 : EsfImated nIS trI.b UfIOD 0f PY 2025 ESRD QIP P aymentRedUC tions Payment Reduction 0.0%
0.5%

18.22%
4.86%
0.95%
0.31%

357
70
23

1.0%
1.5%
2.0%
Note: 372 facilities not scored due to insufficient data To estimate whether a facility would receive a payment reduction in PY 2025, we scored each facility on achievement and improvement on several clinical measures we have previously finalized
Percent of Facilities 75.66%

Number of Facilities 5,557
1,338

and for which there were available data from EQRS and Medicare claims.
Payment reduction estimates were calculated using the most recent data available specified in Table 14 in
accordance with the policies finalized in this final rule. Measures used for the simulation are shown in Table 15.

TABLE15 : Daa t Use dt0 E sfImate PY2025ESRDQIPP aymentRedUCfIODS
Period of time used to calculate achievement thresholds, 50th percentiles of the national performance, benchmarks, and improvement thresholds Jan 2018-Dec 2018
Jan 2018-Dec 2018
Jan 2018-Dec 2018
Jan 2018-Dec 2018
Jan 2018-Dec 2018

Measure
ICH CARPS Survey SRR
SHR
PPPW
Kt/V Dialysis Adequacy Comprehensive VAT
Standardized Fistula Ratio
Jan 2018-Dec 2018

Jan 2019-Dec 2019

Jan 2018-Dec 2018
Jan 2018-Dec 2018

Jan 2019-Dec 2019
Jan 2019-Dec 2019

section 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 2025 for each facility resulting from this proposed 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 16 shows the estimated impact of the finalized ESRD QIP payment
reductions to all ESRD facilities for PY
2025. The table 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 2025 ESRD QIP, the actual impact of the PY 2025 ESRD QIP
may vary significantly from the values provided here.
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For all measures except the SHR
clinical measure, the 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 SHR and SRR, 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 incorporates the policies outlined in
Jan 2019-Dec 2019
Jan 2019-Dec 2019
Jan 2019-Dec 2019
Jan 2019-Dec 2019
Jan 2019-Dec 2019

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