Improving Access to Home Dialysis Act of 2021 This bill provides for Medicare coverage of staff-assisted home dialysis services for certain individuals with end-stage renal disease (ESRD). Specifically, the bill provides for coverage of services for ESRD individuals who are either initiating peritoneal or home hemodialysis or receiving home dialysis and are unable to self-dialyze due to illness, injury, caregiver issues, or other temporary circumstances. The Centers for Medicare & Medicaid Services must develop a payment system for such services. The bill also requires the development of a patient-centered decision tool that includes home dialysis as an option, as well as a report on racial disparities with respect to the use of staff-assisted home dialysis services.