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Federal Register / Vol. 86, No. 129 / Friday, July 9, 2021 / Proposed Rules
ESRD QIP, the actual impact of the PY

2025 ESRD QIP may vary significantly from the values provided here.
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TABLE 16: Estimated Impact of QIP Payment Reductions to ESRD Facilities for PY 2025

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

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 833
4.3
Small Entities 1
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
US Territories 2
60
0.4
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 I 0,000 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.

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d. Effects on Other Providers The ESRD QIP is applicable to dialysis facilities. We are aware that several of our measures impact other providers. For example, with the introduction of the SRR clinical measure in PY 2017 and the SHR
clinical measure in PY 2020, we anticipate that hospitals may experience financial savings as dialysis facilities work to reduce the number of
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unplanned readmissions and hospitalizations. We are exploring various methods to assess the impact these measures have on hospitals and other facilities, such as through the impacts of the Hospital Readmissions Reduction Program and the HospitalAcquired Condition Reduction Program, and we intend to continue examining the interactions between our quality programs to the greatest extent feasible.

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e. Effects on the Medicare Program For PY 2025, we estimate that the ESRD QIP would contribute approximately $17,154,657.12 in Medicare savings. For comparison, Table 17 shows the payment reductions that we estimate will be applied by the ESRD QIP from PY 2018 through PY
2025. This includes our PY 2022 scoring and payment proposals as described in section IV.D of this proposed rule.

E:FRFM09JYP2.SGM

09JYP2

EP09JY21.017

Number of Facilities 7,610
7,224

Number of Treatments 2019 in millions 44.8
43.1

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