{
 "id": "cms:6a0dbf98-e4b0-4037-ac63-1439b08f4a71",
 "slug": "managing-clinician-aggregation-group-performance",
 "source": "data.cms.gov",
 "title": "Managing Clinician Aggregation Group Performance",
 "summary": "The Managing Clinician Aggregation Group Performance dataset provides performance information in the End-Stage Renal Disease (ESRD) Treatment Choices (ETC) Model.",
 "description": "The Managing Clinician 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 Managing Clinician aggregation group. All Managing Clinicians 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 Managing Clinicians.",
 "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": [
  "doctors",
  "quality",
  "hospitals",
  "aco-value-based",
  "dialysis-kidney"
 ],
 "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/managing-clinician-aggregation-group-performance",
 "csv_url": "https://data.cms.gov/sites/default/files/2025-12/8e9da62e-6944-44f3-9e7a-fad66523d9d5/ETC-MY7-MC-ModelDetailedResults.csv",
 "api_url": "https://data.cms.gov/data-api/v1/dataset/6a0dbf98-e4b0-4037-ac63-1439b08f4a71/data",
 "api_kind": "cms-data-api",
 "preview_url": "https://data.cms.gov/data-api/v1/dataset/6a0dbf98-e4b0-4037-ac63-1439b08f4a71/data?size=10",
 "dictionary_url": "https://data.cms.gov/resources/managing-clinician-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": 907,
 "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": "6a0dbf98-e4b0-4037-ac63-1439b08f4a71",
   "posted": "2025-12-22",
   "period_start": "2024-07-01",
   "period_end": "2024-12-31"
  },
  {
   "label": "2024-06-01",
   "uuid": "8e846b71-ab95-4f8d-9884-2975920d35c0",
   "posted": "2025-07-01",
   "period_start": "2024-01-01",
   "period_end": "2024-06-30"
  },
  {
   "label": "2023-12-01",
   "uuid": "aceb449c-e67f-45a5-a288-7c264a837921",
   "posted": "2025-06-09",
   "period_start": "2023-07-01",
   "period_end": "2023-12-31"
  },
  {
   "label": "2023-06-01",
   "uuid": "4315f83a-760b-4aa5-acf0-02c1ff9ed403",
   "posted": "2024-08-09",
   "period_start": "2023-01-01",
   "period_end": "2023-06-30"
  },
  {
   "label": "2022-12-31",
   "uuid": "814e85b5-c8f7-4331-b34c-7cc1eb5a2dab",
   "posted": "2024-02-20",
   "period_start": "2022-07-01",
   "period_end": "2022-12-31"
  },
  {
   "label": "2022-06-30",
   "uuid": "8bcc5f21-3692-4e89-9462-241af027496d",
   "posted": "2023-11-30",
   "period_start": "2022-01-01",
   "period_end": "2022-06-30"
  },
  {
   "label": "2021-12-31",
   "uuid": "04ff35fe-16f5-4b81-83db-c5668a7c8770",
   "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. Within the same Hospital Referral Region, Managing Clinicians in the same group practice are aggregated based on practice Tax Identification Numbers. Managing Clinicians who are affiliated with multiple group practices are aggregated to multiple aggregation groups based on corresponding practice Tax Identification Numbers. Solo practitioners are not aggregated with other Managing Clinicians but will have their 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 for both achievement and improvement 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 beneficiary months, plus one half the total number of nocturnal in-center dialysis 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 Managing Clinicians 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 Managing Clinicians 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 TransplantWaitlist Rate 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 TransplantWaitlist Rate 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_L_MY",
   "label": "Number of ESRD beneficiary-months included in the Living DonorTransplant rate denominator",
   "type": "number",
   "meaning": "The number of attributed ESRD beneficiary months included in the Living Donor Transplant Rate denominator. The Living Donor Transplant Rate's denominator is the sum of the number of attributed ESRD beneficiary months and, if applicable, Pre-emptive Living Donor Transplant beneficiary months at the aggregation group level during the Measurement Year. A Pre-emptive Living Donor Transplant beneficiary is a beneficiary who received a kidney transplant from a living donor prior to beginning dialysis.",
   "source": "cms-dictionary"
  },
  {
   "name": "LDT_NUM_L_MY",
   "label": "Number of Living Donor Transplant beneficiary-months includedin the Living Donor Transplant rate numerator",
   "type": "number",
   "meaning": "Beneficiary months for Living Donor Transplant beneficiaries included in the numerator of the Living Donor Transplant rate for an aggregation group of Managing Clinicians are the sum of the number of months between the beginning of the Measurement Year up to and including the month of the transplant for each attributed Living Donor Transplant beneficiary in an aggregation group.",
   "source": "cms-dictionary"
  },
  {
   "name": "LDT_NUM_R_MY",
   "label": "Number of Pre-emptive Living Donor Transplant beneficiary-months included in the Living Donor Transplant ratenumerator or denominator",
   "type": "number",
   "meaning": "Beneficiary months for Pre-emptive Living Donor Transplant beneficiaries included in the numerator or denominator of the Living Donor Transplant rate for an aggregation group of Managing Clinicians are the sum of the number of months between the beginning of the Measurement Year up to and including the month of the transplant for each attributed Pre-emptive Living Donor Transplant beneficiary in the aggregation group.",
   "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": "BENECNT_PMP_MY",
   "label": "Number of Pre-emptive Living Donor Transplant beneficiaries",
   "type": "number",
   "meaning": "The number of Pre-emptive 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 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": "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 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_L_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 included in the Health Equity Incentive Living Donor Transplant Rate denominator. The Health Equity Incentive Living Donor Transplant Rate's denominator is the sum of the number of DE/LIS beneficiary months and, if applicable, Pre-emptive DE/LIS Living Donor Transplant beneficiary months at the aggregation group level during the Measurement Year. A Pre-emptive Living Donor Transplant beneficiary is a beneficiary who received a kidney transplant from a living donor prior to beginning dialysis. This variable is only applicable in Measurement Year 3 onwards.",
   "source": "cms-dictionary"
  },
  {
   "name": "LDT_NUM_L_DELIS_MY",
   "label": "Number of DE/LIS beneficiary-months included in the Health Equity Incentive Living Donor Transplant Rate numerator",
   "type": "number",
   "meaning": "Dual eligible or Low Income Subsidy recipient (DE/LIS) beneficiary months for Living Donor Transplant beneficiaries included in the numerator for an aggregation group of Managing Clinicians are the sum of the number of months between the beginning of the Measurement Year up to and including the month of the transplant for each attributed DE/LIS Living Donor Transplant beneficiary in an aggregation group. This variable is only applicable from Measurement Year 3 onwards.",
   "source": "cms-dictionary"
  },
  {
   "name": "LDT_NUM_R_DELIS_MY",
   "label": "Number of DE/LIS Pre-emptive Living Donor Transplant beneficiary-months included in the Health Equity Incentive Living Donor Transplant Rate numerator or denominator",
   "type": "number",
   "meaning": "Dual eligible or Low Income Subsidy recipient (DE/LIS) beneficiary months for Pre-emptive Living Donor Transplant beneficiaries included in the numerator or denominator of the Health Equity Incentive Living Donor Transplant rate for an aggregation group of Managing Clinicians are the sum of the number of months between the beginning of the Measurement Year up to and including the month of the transplant for each attributed DE/LIS Pre-emptive Living Donor Transplant beneficiary in the aggregation group. 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": "6a0dbf98-e4b0-4037-ac63-1439b08f4a71|2025-12-22",
 "checked": "2026-10-25",
 "source_name": "data.cms.gov"
}