The National Renal Administrators Association (NRAA) has commissioned Dobson | DaVanzo & Associates, LLC, a health economics and policy consulting firm, to examine the accuracy of Medicare End Stage Renal Disease Prospective Payment System (ESRD PPS) rate setting as influenced by dialysis provider Medicare Cost Reports (MCRs). The study evaluated how MCR data affects payment rates for dialysis services and proposed cost report instruction and content changes to CMS as warranted. This was done by identifying areas where cost are reported inconsistently, patterns of cost which may differentiate sections of the industry and potential flaws in the payment system rooted in cost report data.