Beneficiary Attribution

Background

Attribution or "assignment" is a key program methodology used to identify the beneficiaries associated with an ACO and defines the population for which the ACO is held accountable. Beneficiary assignment lists are used for program operations such as developing quarterly program reports, determining the ACO’s financial and quality performance, and determining whether an ACO is eligible to share in savings or losses. MSSP Track 1 and Track 2 utilize preliminary  prospective assignment with retrospective reconciliation while MSSP Track 1+, Track 3, and the Next Generation ACO Model use prospective assignment. Generally speaking, assignment is determined based on the use of primary care services. NAACOS advocates for CMS to allow ACOs, regardless of track or model, to have the option to choose prospective or retrospective assignment. 

Overview

  • CMS resource: MSSP Shared Savings and Losses and Assignment Methodology 

  • CMS regulations governing MSSP assignment

  • CMMI sample Next Generation ACO participation agreement with description of beneficiary alignment process 

News and Advocacy

  • NAACOS Summary of the Final 2018 Medicare Physician Fee Schedule Rule
  • NAACOS Essentials on MSSP Voluntary Alignment
  • NAACOS resource: The Impact of Retrospective Versus Prospective Attribution on Your ACO 
  • CMS slides reviewing implementation of voluntary MSSP alignment
  • NAACOS submits comments to CMS on the proposed 2018 Medicare Physician Fee Schedule which includes proposals affecting MSSP assignment
    • NAACOS summary of proposed 2018 Medicare PFS available here
  • NAACOS submits comments to CMS on the proposed 2017 Medicare Physician Fee Schedule which includes proposals affecting MSSP assignment
    • NAACOS summary of the proposed 2017 Medicare PFS available here