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OMB Control No: 0938-1450	ICR Reference No: 202305-0938-002
Status: Active	Previous ICR Reference No:
Agency/Subagency: HHS/CMS	Agency Tracking No: CCSQ
Title: End-stage Renal Disease (ESRD) Quality Incentive Program (QIP): Study of Quality and Patient Experience (CMS-10823)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/28/2023
	Date Received in OIRA: 05/11/2023
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2026	36 Months From Approved
Responses	1,945	0	0
Time Burden (Hours)	604	0	0
Cost Burden (Dollars)	0	0	0

Abstract: This project seeks to answer several research questions specific to health outcomes for dialysis patients as measured by the Centers for Medicare & Medicaid Services (CMS) Quality Incentive Program (QIP). In addition to these QIP-specific research questions, CMS seeks to understand several contextual factors that have the potential to affect dialysis facility performance on the QIP To do so, the study team, using primary data collection, will answer the following research questions related to dialysis quality, access to care and health equity, and quality of life: 1) What aspects of patient dialysis care do patients report as a priority? 2) How, if at all, do dialysis facilities evaluate the quality of care they provide? 3) What strategies do providers and dialysis facilities use to improve access to care for underserved populations? 4) What do patients, providers, and stakeholder organizations believe contributes to high quality of life for patients with ESRD? Do perceptions vary by respondent type or respondent characteristics? 5) How do dialysis facilities measure patient satisfaction and quality of life? 6) How do dialysis providers and stakeholder organizations think quality of life for dialysis patients has changed over time? What was the impetus for that change? To answer these research questions, the study team will conduct in-depth interviews with individuals with ESRD, dialysis facility administrators, dialysis facility social workers, nephrologists, corporate representatives from dialysis organizations, representatives from patient advocacy organizations, and transplant center administrators. The findings from this data collection will allow CMS to understand the contextual factors that impact many of the QIP measures that dialysis facilities are held accountable for, thus making policy adjustments to account for these contextual factors.

Authorizing Statute(s): PL: Pub.L. 110 - 275 153(c) Name of Law: Medicare Improvements for Patients and Providers Act (MIPPA) of 2008

Citations for New Statutory Requirements: None

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 78685	12/22/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 28554	05/04/2023
Did the Agency receive public comments on this ICR? No

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
End-stage Renal Disease (ESRD) Quality Incentive Program (QIP): Study of Quality and Patient Experience	CMS-10823, CMS-10823, CMS-10823, CMS-10823, CMS-10823, CMS-10823, CMS-10823, CMS-10823, CMS-10823, CMS-10823	, , , , , , , , ,

ICR Summary of Burden

	Total Approved	Change Due to Agency Discretion
Annual Number of Responses	1,945	1,945
Annual Time Burden (Hours)	604	604
Annual Cost Burden (Dollars)	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new information collection request.

Annual Cost to Federal Government: $70,806

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Denise King 410 786-1013 Denise.King@cms.hhs.gov

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