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We derive this estimate from the number of applications received during the CY 2023 QCDR self- nomination period for the CY 2024 performance period/2026 MIPS payment year, while anticipating that: (1) some QCDRs may face remedial action or termination during the CY 2024 performance period/2026 MIPS payment year, and (2) some intermediaries may electively discontinue participating as a QCDR

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Section 1899(d)(1)(B)(ii) of the Act also provides the Secretary with discretion to adjust the historical benchmark by such other factors as the Secretary determines appropriate. Pursuant to this authority, over time we have adopted a variety of methods to adjust the historical benchmark to meet certain policy goals