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Accountable Care Organizations: Beneficiary Assignment and Shared Savings Payments

The Medicare Shared Savings Program (MSSP), established by section 3022 of the Patient Protection and Affordable Care Act, introduced accountable care organizations (ACOs) into the Medicare program to promote accountability of hospitals, physicians, and other providers for a patient population, coordinate items and services, and encourage investment in infrastructure and redesigned care processes for high-quality and efficient service delivery. We will review the MSSP to determine whether beneficiary assignment to ACOs and shared savings payments for assigned beneficiaries complied with Federal requirements. Our review will determine whether Centers for Medicare & Medicaid Services properly performed the process of assigning beneficiaries to ACOs in the MSSP. We will also examine Centers for Medicare & Medicaid Services's shared savings payments for beneficiaries who were assigned to ACOs under the MSSP to ensure that there is no duplication of payments for the same beneficiaries by other savings programs or initiatives (42 CFR § 425.402 and 42 CFR § 425.114(c)).

Announced or Revised Agency Title Component Report Number(s) Expected Issue Date (FY)
Completed Centers for Medicare & Medicaid Services Accountable Care Organizations: Beneficiary Assignment and Shared Savings Payments Office of Audit Services A-09-17-03010;
various reviews