{
 "id": "cms:4bae4223-a1dc-4b9c-bd7e-d9622461be35",
 "slug": "end-stage-renal-disease-facility-aggregation-group-performance",
 "source": "data.cms.gov",
 "title": "End-Stage Renal Disease Facility Aggregation Group Performance",
 "summary": "The End-Stage Renal Disease (ESRD) Facility Aggregation Group Performance dataset provides performance information in the End-Stage Renal Disease (ESRD) Treatment Choices (ETC) Model.",
 "description": "The End-Stage Renal Disease (ESRD) Facility Aggregation Group Performance dataset provides performance information in the End-Stage Renal Disease (ESRD) Treatment Choices (ETC) Model. The dataset includes information on Performance Payment Adjustment (PPA), Modality Performance Score (MPS), home dialysis rate, and transplant rate, as well as the individual components of each rate for each model participant ESRD facility aggregation group. All ESRD facilities within the same aggregation group share the same performance information. The supplementary aggregation group crosswalk file may be used to map aggregation groups to individual ETC Participant ESRD facilities.",
 "aliases": [],
 "keywords": [
  "Medicare",
  "Original Medicare",
  "Hospitals & Facilities",
  "Outpatient Facilities",
  "Clinics",
  "End Stage Renal Disease Facilities",
  "Value-Based Care",
  "Coordinated Care",
  "Service Delivery Models"
 ],
 "themes": [
  "Medicare"
 ],
 "topics": [
  "quality",
  "dialysis-kidney",
  "hospitals",
  "aco-value-based"
 ],
 "category": "cms-innovation-center-programs",
 "publisher": "Office of Enterprise Data and Analytics (OEDA)",
 "contact": "ETC-CMMI@cms.hhs.gov",
 "landing_url": "https://data.cms.gov/cms-innovation-center-programs/disease-episode-based-payment-models/end-stage-renal-disease-facility-aggregation-group-performance",
 "csv_url": "https://data.cms.gov/sites/default/files/2025-12/ed7f688a-f5d1-4cce-b6e0-538b3ddc2bac/ETC-MY7-DF-ModelDetailedResults.csv",
 "api_url": "https://data.cms.gov/data-api/v1/dataset/4bae4223-a1dc-4b9c-bd7e-d9622461be35/data",
 "api_kind": "cms-data-api",
 "preview_url": "https://data.cms.gov/data-api/v1/dataset/4bae4223-a1dc-4b9c-bd7e-d9622461be35/data?size=10",
 "dictionary_url": "https://data.cms.gov/resources/esrd-facility-aggregation-group-performance-data-dictionary",
 "dictionary_kind": "page",
 "methodology_urls": [
  "https://data.cms.gov/resources/esrd-treatment-choices-etc-model-methodology"
 ],
 "state_column": null,
 "row_count": 433,
 "posted": "2025-12-22",
 "modified": "2025-12-22",
 "period_start": "2021-07-01",
 "period_end": "2024-12-31",
 "latest_period": "2024-07-01 to 2024-12-31",
 "cadence": "twice a year",
 "next_update": null,
 "versions": [
  {
   "label": "2024-12-01",
   "uuid": "4bae4223-a1dc-4b9c-bd7e-d9622461be35",
   "posted": "2025-12-22",
   "period_start": "2024-07-01",
   "period_end": "2024-12-31"
  },
  {
   "label": "2024-06-01",
   "uuid": "b2a836f2-8389-4c22-bab9-ab2cebdb4fd1",
   "posted": "2025-07-01",
   "period_start": "2024-01-01",
   "period_end": "2024-06-30"
  },
  {
   "label": "2023-12-01",
   "uuid": "caee7b92-5e32-4e40-ae18-736bb370dd2c",
   "posted": "2025-06-09",
   "period_start": "2023-07-01",
   "period_end": "2023-12-31"
  },
  {
   "label": "2023-06-01",
   "uuid": "e06cdea4-526d-436b-815e-612c22cec061",
   "posted": "2024-08-09",
   "period_start": "2023-01-01",
   "period_end": "2023-06-30"
  },
  {
   "label": "2022-12-31",
   "uuid": "f56b3953-76ba-4b3a-a76a-725ac6a78ae7",
   "posted": "2024-02-20",
   "period_start": "2022-07-01",
   "period_end": "2022-12-31"
  },
  {
   "label": "2022-06-30",
   "uuid": "a587a99b-4669-485d-99a5-68050ba8b3fe",
   "posted": "2023-11-30",
   "period_start": "2022-01-01",
   "period_end": "2022-06-30"
  },
  {
   "label": "2021-12-31",
   "uuid": "ef13fb2d-d276-42c5-8c81-400cfcb089e5",
   "posted": "2023-11-30",
   "period_start": "2021-07-01",
   "period_end": "2021-12-31"
  }
 ],
 "columns": [
  {
   "name": "AGG_ID",
   "label": "Aggregation Group ID",
   "type": "string",
   "meaning": "The Aggregation Group ID. The aggregation group for a subsidiary ESRD facility includes all ESRD facilities owned in whole or in part by the same legal entity located in the same Hospital Referral Region in which the ESRD facility is located. An ESRD facility that is not a Subsidiary ESRD facility is not included in an aggregation group but will have its own aggregation group ID.",
   "source": "cms-dictionary"
  },
  {
   "name": "HRR_NUM_MY",
   "label": "Hospital Referral Region Number",
   "type": "number",
   "meaning": "The Hospital Referral Region number during the Measurement Year.",
   "source": "cms-dictionary"
  },
  {
   "name": "HDR_MY",
   "label": "Home Dialysis Rate used to calculate both achievement andimprovement scores",
   "type": "number",
   "meaning": "For Measurement Year 1 and Measurement Year 2, the Home Dialysis Rate for an aggregation group is the percent of attributed ESRD beneficiary months in which ESRD beneficiaries received dialysis at home or self-dialysis in-center during the Measurement Year. For Measurement Year 3 through Measurement Year 10, the Home Dialysis Rate for an aggregation group is the percent of attributed ESRD beneficiary months in which ESRD beneficiaries received dialysis at home, or self-dialysis in-center, or nocturnal in-center dialysis. The same Home Dialysis Rate is used for achievement scoring and improvement scoring.",
   "source": "cms-dictionary"
  },
  {
   "name": "HDR_DNM_MY",
   "label": "Number of ESRD beneficiary-months included in the Home DialysisRate denominator",
   "type": "number",
   "meaning": "The Home Dialysis Rate's denominator is the number of attributed ESRD beneficiary months at the aggregation group level during the Measurement Year.",
   "source": "cms-dictionary"
  },
  {
   "name": "HDR_NUM_MY",
   "label": "Number of ESRD beneficiary-months included in the Home DialysisRate numerator",
   "type": "number",
   "meaning": "For Measurement Year 1 and Measurement Year 2, the Home Dialysis Rate's numerator is the number of home dialysis treatment beneficiary months for attributed ESRD beneficiaries during the Measurement Year plus one half the total number of self-dialysis in-center treatment beneficiary months. For Measurement Year 3 through Measurement Year 10, the Home Dialysis Rate's numerator is the number of home dialysis treatment beneficiary months for attributed ESRD beneficiaries during the Measurement Year, plus one half the total number of self-dialysis in-center treatment beneficiary months, plus one half the total number of nocturnal in-center dialysis treatment beneficiary months.",
   "source": "cms-dictionary"
  },
  {
   "name": "HD_NUM_MY",
   "label": "Number of home dialysis beneficiary-months",
   "type": "number",
   "meaning": "The number of months during which attributed ESRD beneficiaries received maintenance dialysis at home.",
   "source": "cms-dictionary"
  },
  {
   "name": "SD_NUM_MY",
   "label": "Number of in-center self dialysis beneficiary-months",
   "type": "number",
   "meaning": "The number of months during which attributed ESRD beneficiaries received self-dialysis in-center.",
   "source": "cms-dictionary"
  },
  {
   "name": "NOCD_NUM_MY",
   "label": "Number of nocturnal in-center dialysis beneficiary months",
   "type": "number",
   "meaning": "The number of months during which attributed ESRD beneficiaries received nocturnal in-center dialysis. This variable is only applicable from Measurement Year 3 onwards.",
   "source": "cms-dictionary"
  },
  {
   "name": "TR_MY_ACHSCR",
   "label": "Transplant rate used to calculate achievement score",
   "type": "number",
   "meaning": "The Transplant Rate for an aggregation group of ESRD facilities is the sum of the Transplant Waitlist Rate and Living Donor Transplant Rate. The Transplant Rate displayed here is used for achievement scoring. For transplant, the achievement scoring rate differs slightly from the improvement scoring rate due to differences in reference population groups used for risk adjusting transplant waitlist rates in the Measurement Year.",
   "source": "cms-dictionary"
  },
  {
   "name": "TR_MY_IMPSCR",
   "label": "Transplant rate used to calculate improvement score",
   "type": "number",
   "meaning": "The Transplant Rate for an aggregation group of ESRD facilities is the sum of the Transplant Waitlist Rate and Living Donor Transplant Rate. The Transplant Waitlist Rate and Living Donor Transplant Rate do not include beneficiary months from beneficiaries who are 75 years of age or older at any point during the month. For Measurement Year 3 through Measurement Year 10, the Transplant Waitlist Rate and Living Donor Transplant Rate also do not include beneficiary months from beneficiaries who had a vital solid organ cancer diagnosis and were receiving treatment with chemotherapy or radiation for vital solid organ cancer during the Measurement Year. The Transplant Rate displayed here is used for improvement scoring. For transplant, the achievement scoring rate differs slightly from the improvement scoring rate due to differences in reference population groups used for risk adjusting transplant waitlist rates in the Measurement Year.",
   "source": "cms-dictionary"
  },
  {
   "name": "TWR_DNM_MY",
   "label": "Number of ESRD beneficiary-months included in the Transplant WaitlistRate denominator",
   "type": "number",
   "meaning": "The Transplant Waitlist Rate's denominator is the number of attributed ESRD beneficiary months at the aggregation group level during the Measurement Year.",
   "source": "cms-dictionary"
  },
  {
   "name": "TWR_NUM_MY",
   "label": "Number of ESRD beneficiary-months included in the Transplant WaitlistRate numerator",
   "type": "number",
   "meaning": "The Transplant Waitlist Rate's numerator is the number of attributed ESRD beneficiary months at the aggregation group level during the Measurement Year for which attributed ESRD beneficiaries were on the kidney transplant waitlist.",
   "source": "cms-dictionary"
  },
  {
   "name": "LDT_DNM_MY",
   "label": "Number of ESRD beneficiary-months included in the Living DonorTransplant rate denominator",
   "type": "number",
   "meaning": "The Living Donor Transplant Rate's denominator is the number of attributed ESRD beneficiary months at the aggregation group level during the Measurement Year. For each aggregation group of ESRD facilities, the Living Donor Transplant Rate's denominator is the same as its Transplant Waitlist Rate's denominator.",
   "source": "cms-dictionary"
  },
  {
   "name": "LDT_NUM_MY",
   "label": "Number of Living Donor Transplant beneficiary-months includedin the Living Donor Transplant rate numerator",
   "type": "number",
   "meaning": "The Living Donor Transplant Rate's numerator is the number of attributed beneficiary months for living donor transplant beneficiaries at the aggregation group level during the Measurement Year. Beneficiary months included in the numerator are composed of those months between the beginning of the Measurement Year up to and including the month of the transplant for Living Donor Transplant beneficiaries attributed to an ESRD facility during the month of the transplant.",
   "source": "cms-dictionary"
  },
  {
   "name": "BENECNT_LDT_MY",
   "label": "Number of Living Donor Transplant beneficiaries",
   "type": "number",
   "meaning": "The number of Living Donor Transplant beneficiaries during the Measurement Year.",
   "source": "cms-dictionary"
  },
  {
   "name": "HEI_HDR",
   "label": "Health Equity Incentive for Home Dialysis Improvement Score",
   "type": "number",
   "meaning": "From Measurement Year 3 onwards, CMS incentivizes ETC Participants to decrease disparities in the Home Dialysis Rate and the Transplant Rate between beneficiaries who are dual-eligible or Low-Income Subsidy recipients (DE/LIS) and those who are not by adding a Health Equity Incentive to the improvement scoring methodology. An ETC Participant earns the Health Equity Incentive for the Home Dialysis Rate improvement score if the Home Dialysis Rate for the Measurement Year is at least 2.5 percentage points higher than the corresponding Benchmark Year rate for attributed ESRD beneficiaries who are dual-eligible or DE/LIS. If the ETC Participant earns the Health Equity Incentive for the Home Dialysis Rate improvement score, CMS adds 0.5 points to the ETC Participant's Home Dialysis Rate improvement score. This variable is only applicable from Measurement Year 3 onwards.",
   "source": "cms-dictionary"
  },
  {
   "name": "HDR_DELIS_DIFF",
   "label": "Health Equity Incentive Home Dialysis Rate Difference Between BY and MY",
   "type": "number",
   "meaning": "The difference between the Benchmark Year and Measurement Year in the Home Dialysis Rate for attributed ESRD beneficiaries who are dual eligible or Low Income Subsidy recipients (DE/LIS). This variable is only applicable from Measurement Year 3 onwards.",
   "source": "cms-dictionary"
  },
  {
   "name": "HDR_DELIS_MY",
   "label": "Health Equity Incentive Home Dialysis Rate in the MY",
   "type": "number",
   "meaning": "The Home Dialysis Rate in the Measurement Year for attributed ESRD beneficiaries who are dual eligible or Low Income Subsidy recipients (DE/LIS). This variable is only applicable from Measurement Year 3 onwards.",
   "source": "cms-dictionary"
  },
  {
   "name": "HDR_DNM_DELIS_MY",
   "label": "Number of DE/LIS beneficiary-months included in the Health Equity Incentive Home Dialysis Rate denominator",
   "type": "number",
   "meaning": "The Health Equity Incentive Home Dialysis Rate's denominator is the number of attributed ESRD beneficiary months at the aggregation group level during the Measurement Year for attributed ESRD beneficiaries who are dual eligible or Low Income Subsidy recipients (DE/LIS). This variable is only applicable from Measurement Year 3 onwards.",
   "source": "cms-dictionary"
  },
  {
   "name": "HDR_NUM_DELIS_MY",
   "label": "Number of DE/LIS beneficiary-months included in the Health Equity Incentive Home Dialysis Rate numerator",
   "type": "number",
   "meaning": "The Health Equity Incentive Home Dialysis Rate's numerator is the number of home dialysis treatment beneficiary months, plus one half the total number of self-dialysis in-center treatment beneficiary months, plus one half the total number of nocturnal in-center dialysis treatment beneficiary months during the Measurement Year, for attributed ESRD beneficiaries who are dual eligible or Low Income Subsidy recipients (DE/LIS). This variable is only applicable from Measurement Year 3 onwards.",
   "source": "cms-dictionary"
  },
  {
   "name": "HEI_TR",
   "label": "Health Equity Incentive for Transplant Improvement Score",
   "type": "number",
   "meaning": "From Measurement Year 3 onwards, CMS incentivizes ETC Participants to decrease disparities in the Home Dialysis Rate and the Transplant Rate between beneficiaries who are dual-eligible or Low-Income Subsidy recipients (DE/LIS) and those who are not by adding a Health Equity Incentive to the improvement scoring methodology. An ETC Participant earns the Health Equity Incentive for the Transplant Rate improvement score if the Transplant Rate for the Measurement Year is at least 2.5 percentage points higher than the corresponding Benchmark Year rate for attributed ESRD beneficiaries who are dual-eligible or DE/LIS. If the ETC Participant earns the Health Equity Incentive for the Transplant Rate improvement score, CMS adds 0.5 points to the ETC Participant's transplant rate improvement score. This variable is only applicable from Measurement Year 3 onwards.",
   "source": "cms-dictionary"
  },
  {
   "name": "TR_DELIS_DIFF",
   "label": "Health Equity Incentive Transplant Rate Difference Between BY and MY",
   "type": "number",
   "meaning": "The difference between the Benchmark Year and Measurement Year in the Transplant Rate for attributed ESRD beneficiaries who are dual eligible or Low Income Subsidy recipients (DE/LIS). This variable is only applicable from Measurement Year 3 onwards.",
   "source": "cms-dictionary"
  },
  {
   "name": "TR_DELIS_MY",
   "label": "Health Equity Incentive for Transplant Rate in the MY",
   "type": "number",
   "meaning": "The Transplant Rate in the Measurement Year for attributed ESRD beneficiaries who are dual eligible or Low Income Subsidy recipients (DE/LIS). This variable is only applicable from Measurement Year 3 onwards.",
   "source": "cms-dictionary"
  },
  {
   "name": "TWR_DNM_DELIS_MY",
   "label": "Number of DE/LIS beneficiary-months included in the Health Equity Incentive Transplant Waitlist Rate denominator",
   "type": "number",
   "meaning": "The number of dual eligible or Low Income Subsidy recipient (DE/LIS) beneficiary months at the aggregation group level during the Measurement Year included in the Health Equity Incentive Transplant Waitlist Rate denominator. This variable is only applicable from Measurement Year 3 onwards.",
   "source": "cms-dictionary"
  },
  {
   "name": "TWR_NUM_DELIS_MY",
   "label": "Number of DE/LIS beneficiary-months included in the Health Equity Incentive Transplant Waitlist Rate numerator",
   "type": "number",
   "meaning": "The number of dual eligible or Low Income Subsidy (DE/LIS) beneficiary months at the aggregation group level during the Measurement Year for which DE/LIS beneficiaries were on the kidney transplant waitlist. This variable is only applicable from Measurement Year 3 onwards.",
   "source": "cms-dictionary"
  },
  {
   "name": "LDT_DNM_DELIS_MY",
   "label": "Number of DE/LIS beneficiary-months included in the Health Equity Incentive Living Donor Transplant Rate denominator",
   "type": "number",
   "meaning": "The number of dual eligible or Low Income Subsidy (DE/LIS) beneficiary months at the aggregation group level during the Measurement Year. For each aggregation group of ESRD facilities, the Living Donor Transplant Rate's denominator is the same as its Transplant Waitlist Rate's denominator. This variable is only applicable from Measurement Year 3 onwards.",
   "source": "cms-dictionary"
  },
  {
   "name": "LDT_NUM_DELIS_MY",
   "label": "Number of DE/LIS beneficiary-months included in the Health Equity Incentive Living Donor Transplant Rate numerator",
   "type": "number",
   "meaning": "The number of dual eligible or Low Income Subsidy (DE/LIS) beneficiary months for living donor transplant beneficiaries at the aggregation group level during the Measurement Year. This variable is only applicable from Measurement Year 3 onwards.",
   "source": "cms-dictionary"
  },
  {
   "name": "MPS",
   "label": "Modality Performance Score",
   "type": "number",
   "meaning": "The Modality Performance Score is a weighted sum of the higher of the achievement score or the improvement score for the ETC Participant's Home Dialysis Rate and Transplant Rate. For Measurement Year 1 and Measurement Year 2 the MPS=2×(The higher of the home dialysis rate achievement or improvement score)+(The higher of the transplant rate achievement or improvement score). For Measurement Year 3 through Measurement Year 10, the MPS=2×(The higher of the home dialysis achievement or (home dialysis improvement score + Health Equity Bonus))+(The higher of the transplant achievement or (transplant improvement score + Health Equity Bonus)).",
   "source": "cms-dictionary"
  },
  {
   "name": "PPA",
   "label": "Performance Payment Adjustment",
   "type": "number",
   "meaning": "The Performance Period Adjustment (PPA) is an upward or downward payment adjustment that is made on all dialysis claims with claim service dates during the corresponding PPA period based on an ETC Participant's Home Dialysis Rate and Transplant Rate related performance during the Measurement Year.",
   "source": "cms-dictionary"
  },
  {
   "name": "PPA_PERIOD",
   "label": "Performance Payment Adjustment Period",
   "type": "number",
   "meaning": "The 6-month period during which the payments are adjusted based on ETC Participants' performance in each Measurement Year. PPA Period 1: 07/01/2022-12/31/2022 PPA Period 2: 01/01/2023-06/30/2023 PPA Period 3: 07/01/2023-12/31/2023 PPA Period 4: 01/01/2024-06/30/2024 PPA Period 5: 07/01/2024-12/31/2024 PPA Period 6: 01/01/2025-06/30/2025 PPA Period 7: 07/01/2025-12/31/2025 PPA Period 8: 01/01/2026-06/30/2026 PPA Period 9: 07/01/2026-12/31/2026 PPA Period 10: 01/01/2027-06/30/2027",
   "source": "cms-dictionary"
  },
  {
   "name": "MY",
   "label": "Measurement Year",
   "type": "number",
   "meaning": "The 12-month period for which achievement and improvement on the home dialysis rate and transplant rate are assessed for the purpose of calculating ETC Participants' MPS and PPA. MY1: 01/01/2021-12/31/2021 MY2: 07/01/2021-06/30/2022 MY3: 01/01/2022-12/31/2022 MY4: 07/01/2022-06/30/2023 MY5: 01/01/2023-12/31/2023 MY6: 07/01/2023-06/30/2024 MY7: 01/01/2024-12/31/2024 MY8: 07/01/2024-06/30/2025 MY9:01/01/2025-12/31/2025 MY10: 07/01/2025-06/30/2026",
   "source": "cms-dictionary"
  }
 ],
 "caveats": [],
 "curated": false,
 "license": "https://www.usa.gov/government-works",
 "detail_key": "4bae4223-a1dc-4b9c-bd7e-d9622461be35|2025-12-22",
 "checked": "2026-10-25",
 "source_name": "data.cms.gov"
}