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. Generally speaking, assignment is determined based on the use of primary care services. CMS provides Basic and Enhanced Track ACOs the choice between prospective assignment or preliminary prospective assignment with retrospective reconciliation for agreement periods beginning July 1, 2019, and thereafter. The change was included in the final Pathways to Success rule and supported by NAACOS. The ACO REACH Model uses prospective assignment.
Overview
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