ACO Shared Savings Program Public Use File 2014-2016

$199 / year

This dataset shows the 2014 to 2016 Shared Savings Program (SSP) Accountable Care Organization (ACO) data Public Use File (PUF), which has been updated to include for each ACO the mean final prospective Centers for Medicare and Medicaid Service’s (CMS) Hierarchical Condition Category (HCC) risk score for the four Medicare enrollment types (End-Stage Renal Disease (ESRD), disabled, aged/dual, aged/non-dual) for each of the benchmark year.

Complexity

This dataset addresses the increasing number of requests for SSP ACO data, the Centers for Medicare and Medicaid Services (CMS) has created a standard analytical file that CMS can use to efficiently satisfy these requests. It is the intent of CMS to publish the ACO-level public-use file (PUF) that contains ACO-specific metrics as well as summarized beneficiary and provider information for each performance year of the SSP program.

The risk scores used in this dataset are based on the applicable risk adjustment model for the applicable year and renormalized so that the mean national Fee-For-Services (FFS) risk score equals 1.0. Risk scores for each enrollment type are renormalized to their own populations and thus are not on the same scale and not comparable.

The Shared Savings Program has different tracks that allow ACOs to select an arrangement that makes the most sense for their organization.

Date Created

2015-10-30

Last Modified

2017-11-07

Version

2017-11-07

Update Frequency

Annual

Temporal Coverage

2014-2016

Spatial Coverage

United States

Source

John Snow Labs => Centers for Medicare and Medicaid Services (CMS) and Medicare Shared Savings Program (MSSP)

Source License URL

John Snow Labs Standard License

Source License Requirements

N/A

Source Citation

N/A

Keywords

Medicare Shared Savings Program, ACO Data, ACO Healthcare, Medicare ACO, Healthcare ACO, Shared Savings Program, Medicare Shared Savings Program, Public Use File, ACO, Coordinated Care, Medicare

Other Titles

What is an ACO?, ACO Public Use File 2016, ACO Shared Savings Program PUF 2016, Accountable Care Organization SSP PUF 2016

NameDescriptionTypeConstraints
ACO_YearCoverage year of Medicare Shared Savings Program Performance Accountable Care Organizations (ACO) (2014, 2015 and 2016)string-
ACO_NumberEncrypted ACO Identifier. Identifier is consistent across performance years.string-
ACO_NameACO Doing Business As (DBA) or Legal Business Name (LBN).string-
ACO_StateAssigned beneficiary state(s) of residence.string-
Start_DateAgreement start date.date-
Total_Assigned_BeneficiariesNumber of assigned beneficiaries, performance year.integerlevel : Ratio
Saving_RateTotal Benchmark Expenditures Minus Assigned Beneficiary Expenditures as a percent of Total Benchmark Expenditures.number-
Min_Saving_Percentagenumber-
Benchmark_Minus_ExpenditureTotal Benchmark Expenditures Minus Assigned Beneficiary Expenditures. If positive, represents total savings. If negative, represents total losses.integerlevel : Ratio
General_Save_Loss(Gross) Generated savings: Total savings (measured as Benchmark Minus Expenditures, from first to last dollar) for ACOs whose savings rate equaled or exceeded their minimum savings rate. This amount does not account for the application of the ACO’s final sharing rate based on quality performance, reduction due to sequestration or repayment of advance payments.integerlevel : Ratio
Earned_Save_LossTotal earned shared savings: The ACO’s share of savings for ACOs whose savings rate equaled or exceeded their minimum savings rate, and who were eligible for a performance payment because they met the program’s quality performance standard. This amount accounts for the application of the ACO’s final sharing rate based on quality performance (not to exceed 50% under Track 1 or 60% under Track 2), as well as the reduction in performance payment due to sequestration and application of the performance payment limit. This amount does not account for repayment of advance payments.integerlevel : Ratio
Quality_ScoreACOs with 2015 start dates will have a “P4R” (Pay for Reporting) displayed for the Quality Score to reflect that their quality performance is based on complete and accurate reporting.numberlevel : Ratio
Updated_Benchmark_ExpenditureBenchmark expenditures are risk-adjusted in the historical benchmark period and performance period to account for changes in the ACO's assigned populations over time.integerlevel : Ratio
History_Benchmark3-year average historical benchmark, risk adjusted. Historical benchmark expenditures are risk-adjusted by applying risk ratios of the BY3 risk score divided by each year’s risk score to the BY1 and BY2 expenditures.integerlevel : Ratio
Total_Benchmark_ExpenditurePer capita benchmark (UpdatedBnchmk) multiplied by total person-years (N_AB_Year).integerlevel : Ratio
Total_ExpenditurePer capita performance year expenditures (Per_Capita_Exp_TOTAL) multiplied by total person-years (N_AB_Year).integerlevel : Ratio
Advance_Payment_Amountintegerlevel : Ratio
Advance_Payment_Recoupmentnumberlevel : Ratio
Quality_Performance_ShareSet at 50 percent for Track 1 ACOs and 60 percent for Track 2 ACOs.numberlevel : Ratio
Final_Sharing_RateQuality performance sharing rate (QualPerfShare) multiplied by quality score (QualScore). The percentage of savings an ACO shares if the ACO is eligible for shared savings. Will equal zero if ACO failed to meet quality performance standard.numberlevel : Ratio
Per_Capita_Exp_All_ESRD_by_Year1Annualized, truncated, weighted mean total expenditures per ESRD assigned beneficiary person years in benchmark year 1.integerlevel : Ratio
Per_Capita_Exp_All_Disabled_by_Year1Annualized, truncated, weighted mean total expenditures per DISABLED assigned beneficiary person years in benchmark year 1.integerlevel : Ratio
Per_Capita_Exp_All_AGDU_by_Year1Annualized, truncated, weighted mean total expenditures per AGED/DUAL assigned beneficiary person years in benchmark year 1.integerlevel : Ratio
Per_Capita_Exp_All_AGND_by_Year1Annualized, truncated, weighted mean total expenditures per AGED/NON-DUAL assigned beneficiary person years in benchmark year 1.integerlevel : Ratio
Per_Capita_Exp_All_ESRD_by_Year2Annualized, truncated, weighted mean total expenditures per ESRD assigned beneficiary person years in benchmark year 2.integerlevel : Ratio
Per_Capita_Exp_All_Disabled_by_Year2Annualized, truncated, weighted mean total expenditures per DISABLED assigned beneficiary person years in benchmark year 2.integerlevel : Ratio
Per_Capita_Exp_All_AGDU_by_Year2Annualized, truncated, weighted mean total expenditures per AGED/DUAL assigned beneficiary person years in benchmark year 2.integerlevel : Ratio
Per_Capita_Exp_All_AGND_by_Year2Annualized, truncated, weighted mean total expenditures per AGED/NON-DUAL assigned beneficiary person years in benchmark year 2.integerlevel : Ratio
Per_Capita_Exp_All_ESRD_by_Year3Annualized, truncated, weighted mean total expenditures per ESRD assigned beneficiary person years in benchmark year 3.integerlevel : Ratio
Per_Capita_Exp_All_Disabled_by_Year3Annualized, truncated, weighted mean total expenditures per DISABLED assigned beneficiary person years in benchmark year 3.integerlevel : Ratio
Per_Capita_Exp_All_AGDU_by_Year3Annualized, truncated, weighted mean total expenditures per AGED/DUAL assigned beneficiary person years in benchmark year 3.integerlevel : Ratio
Per_Capita_Exp_All_AGND_by_Year3Annualized, truncated, weighted mean total expenditures per AGED/NON-DUAL assigned beneficiary person years in benchmark year 3.integerlevel : Ratio
Per_Capita_Exp_All_ESRD_Performance_YearAnnualized, truncated, weighted mean total expenditures per ESRD assigned beneficiary person years in the performance year.integerlevel : Ratio
Per_Capita_Exp_All_Disbled_Performance_YearAAnnualized, truncated, weighted mean total expenditures per DISABLED assigned beneficiary person years in the performance year.integerlevel : Ratio
Per_Capita_Exp_All_AGDU_Performance_YearAnnualized, truncated, weighted mean total expenditures per AGED/DUAL assigned beneficiary person years in the performance year.integerlevel : Ratio
Per_Capita_Exp_All_AGND_Performance_YearAnnualized, truncated, weighted mean total expenditures per AGED/NON-DUAL assigned beneficiary person years in the performance year.integerlevel : Ratio
Per_Capita_Exp_Total_Performance_YearAnnualized, truncated, weighted mean total expenditures per assigned beneficiary person years in the performance year.integerlevel : Ratio
CMS_HCC_Risk_Score_ESRD_BY1Final, mean prospective CMS-HCC risk score for ESRD enrollment type in benchmark year 1numberlevel : Ratio
CMS_HCC_Risk_Score_Disabled_BY1Final, mean prospective CMS-HCC risk score for DISABLED enrollment type in benchmark year 1numberlevel : Ratio
CMS_HCC_Risk_Score_AGDU_BY1Final, mean prospective CMS-HCC risk score for AGED/DUAL enrollment type in benchmark year 1numberlevel : Ratio
CMS_HCC_Risk_Score_AGND_BY1Final, mean prospective CMS-HCC risk score for AGED/NON-DUAL enrollment type in benchmark year 1numberlevel : Ratio
CMS_HCC_Risk_Score_ESRD_BY2Final, mean prospective CMS-HCC risk score for ESRD enrollment type in benchmark year 2numberlevel : Ratio
CMS_HCC_Risk_Score_DIS_BY2Final, mean prospective CMS-HCC risk score for DISABLED enrollment type in benchmark year 2numberlevel : Ratio
CMS_HCC_Risk_Score_AGDU_BY2Final, mean prospective CMS-HCC risk score for AGED/DUAL enrollment type in benchmark year 2numberlevel : Ratio
CMS_HCC_Risk_Score_AGND_BY2Final, mean prospective CMS-HCC risk score for AGED/NON-DUAL enrollment type in benchmark year 2numberlevel : Ratio
CMS_HCC_Risk_Score_ESRD_BY3Final, mean prospective CMS-HCC risk score for ESRD enrollment type in benchmark year 3numberlevel : Ratio
CMS_HCC_Risk_Score_DIS_BY3Final, mean prospective CMS-HCC risk score for DISABLED enrollment type in benchmark year 3numberlevel : Ratio
CMS_HCC_Risk_Score_AGDU_BY3Final, mean prospective CMS-HCC risk score for AGED/DUAL enrollment type in benchmark year 3numberlevel : Ratio
CMS_HCC_Risk_Score_AGND_BY3Final, mean prospective CMS-HCC risk score for AGED/NON-DUAL enrollment type in benchmark year 3numberlevel : Ratio
CMS_HCC_Risk_Score_ESRD_Performance_YearFinal, mean prospective CMS-HCC risk score for ESRD enrollment type in the performance yearnumberlevel : Ratio
CMS_HCC_Risk_Score_DIS_Performance_YearFinal, mean prospective CMS-HCC risk score for DISABLED enrollment type in the performance yearnumberlevel : Ratio
CMS_HCC_Risk_Score_AGDU_Performance_YearFinal, mean prospective CMS-HCC risk score for AGED/DUAL enrollment type in the performance yearnumberlevel : Ratio
CMS_HCC_Risk_Score_AGND_Performance_YearFinal, mean prospective CMS-HCC risk score for AGED/NON-DUAL enrollment type in the performance year.numberlevel : Ratio
ESRD_Person_Years_in_Benchmark_Year3Number of assigned beneficiaries with ESRD enrollment type in benchmark year 3 adjusted for the total number of months that each beneficiary was classified as ESRD; Number of ESRD person-months divided by 12numberlevel : Ratio
Disabled_Person_Years_in_Benchmark_Year3Number of assigned beneficiaries with DISABLED enrollment type in benchmark year 3 adjusted for the total number of months that each beneficiary was classified as DISABLED; Number of DISABLED person-months divided by 12numberlevel : Ratio
Aged_Dual_Person_Years_in_Benchmark_Year3Number of assigned beneficiaries with AGED/DUAL enrollment type in benchmark year 3 adjusted for the total number of months that each beneficiary was classified as AGED/DUAL; Number of AGED/DUAL person-months divided by 12numberlevel : Ratio
Aged_Non_Dual_Person_Years_in_Benchmark_Year3Number of assigned beneficiaries with AGED/NON-DUAL enrollment type in benchmark year 3 adjusted for the total number of months that each beneficiary was classified as AGED/NON-DUAL; Number of AGED/NON-DUAL person-months divided by 12numberlevel : Ratio
Total_Person_Years_in_Performance_YearNumber of assigned beneficiaries in the performance year adjusted downwards for beneficiaries with less than a full 12 months of eligibility ; Number of person-months divided by 12numberlevel : Ratio
ESRD_Person_Years_in_Performance_YearNumber of assigned beneficiaries with ESRD enrollment type in the performance year adjusted for the total number of months that each beneficiary was classified as ESRD; Number of ESRD person-months divided by 12numberlevel : Ratio
Disabled_Person_Years_in_Performance_YearNumber of assigned beneficiaries with DISABLED enrollment type in the performance year adjusted for the total number of months that each beneficiary was classified as DISABLED; Number of DISABLED person-months divided by 12numberlevel : Ratio
AGED_DUAL_Person_Years_in_Performance_YearNumber of assigned beneficiaries with AGED/DUAL enrollment type in the performance year adjusted for the total number of months that each beneficiary was classified as AGED/DUAL; Number of AGED/DUAL person-months divided by 12numberlevel : Ratio
AGED_NON_DUAL_Person_Years_in_Performance_YearNumber of assigned beneficiaries with AGED/NON-DUAL enrollment type in the performance year adjusted for the total number of months that each beneficiary was classified as AGED/NON-DUAL; Number of AGED/NON-DUAL person-months divided by 12numberlevel : Ratio
Total_Assigned_Beneficiaries_Age_0_To_64Total number of assigned beneficiaries, age 0-64 in CY2016; age calculated as of 2/1/2016. Based on most current date of birth in Medicare records.integerlevel : Ratio
Total_Assigned_Beneficiaries_Age_65_To_74Total number of assigned beneficiaries, age 65-74 in CY2016; age calculated as of 2/1/2016. Based on most current date of birth in Medicare records.integerlevel : Ratio
Total_Assigned_Beneficiaries_Age_75_To_84Total number of assigned beneficiaries, age 75-84 in CY2016; age calculated as of 2/1/2016. Based on most current date of birth in Medicare records.integerlevel : Ratio
Total_Assigned_Beneficiaries_Age_85_PlusTotal number of assigned beneficiaries, age 85+ in CY2016; age calculated as of 2/1/2016. Based on most current date of birth in Medicare records.integerlevel : Ratio
Total_Assigned_Beneficiaries_FemaleTotal number of assigned beneficiaries, female (Gender=2) in CY2016. Based on most current gender in Medicare records.integerlevel : Ratio
Total_Assigned_Beneficiaries_MaleTotal number of assigned beneficiaries, male (Gender=1) in CY2016. Based on most current gender in Medicare records.integerlevel : Ratio
Total_Assigned_Beneficiaries_Race_WhiteTotal number of assigned beneficiaries, Non-Hispanic White (Race=1) in CY2016. Based on most current race in Medicare records.integerlevel : Ratio
Total_Assigned_Beneficiaries_Race_BlackTotal number of assigned beneficiaries, Black (Race=2) in CY2016. Based on most current race in Medicare records.integerlevel : Ratio
Total_Assigned_Beneficiaries_Race_AsianTotal number of assigned beneficiaries, Asian (Race=4) in CY2016. Based on most current race in Medicare records.integerlevel : Ratio
Total_Assigned_Beneficiaries_Race_HispTotal number of assigned beneficiaries, Hispanic (Race=5) in CY2016. Based on most current race in Medicare records.integerlevel : Ratio
Total_Assigned_Beneficiaries_Race_NativeTotal number of assigned beneficiaries, North American Native (Race=6) in CY2016. Based on most current race in Medicare records.integerlevel : Ratio
Total_Assigned_Beneficiaries_Race_OtherTotal number of assigned beneficiaries, Other (Race=0,3,~) in CY2016. Based on most current race in Medicare records.integerlevel : Ratio
Total_Inpatient_ExpendituresAnnualized, truncated, weighted mean expenditures per assigned beneficiary person years for inpatient services for assigned beneficiaries in the performance year. Includes all hospital provider types including but not limited to short term acute care hospital, long term care hospital, rehabilitation hospital or unit, and psychiatric hospital or unit.integerlevel : Ratio
Short_Term_Care_Hospital_ExpenditureAnnualized, truncated, weighted mean expenditures per assigned beneficiary person years for acute care inpatient services in a short term acute care (Inpatient Prospective Payment System (IPPS) or Critical Access Hospital (CAH)) setting for assigned beneficiaries in the performance year.integerlevel : Ratio
Long_Term_Care_Hospital_ExpenditureAnnualized, truncated, weighted mean expenditures per assigned beneficiary person years for inpatient services in a long term care setting for assigned beneficiaries in the performance year.integerlevel : Ratio
Inpatient_Rehabilitation_Facility_ExpendituresAnnualized, truncated, weighted mean expenditures per assigned beneficiary person years for inpatient services in a rehabilitation facility or unit for assigned beneficiaries in the performance year.integerlevel : Ratio
Inpatient_Psychiatric_Hospital_ExpendituresAnnualized, truncated, weighted mean expenditures per assigned beneficiary person years for inpatient services in a psychiatric hospital facility or unit for assigned beneficiaries in the performance year.integerlevel : Ratio
Hospice_ExpendituresAnnualized, truncated, weighted mean expenditures per assigned beneficiary person years for hospice services for assigned beneficiaries in the performance year. Hospice claims are identified by claim type code 50.integerlevel : Ratio
Skilled_Nursing_Facility_or_Unit_ExpendituresAnnualized, truncated, weighted mean expenditures per assigned beneficiary person years for services in a skilled nursing facility (SNF) setting for assigned beneficiaries in the performance year. SNF claims are identified by claim type codes 20 and 30)integerlevel : Ratio
Other_Inpatient_ExpendituresAnnualized, truncated, weighted mean expenditures per assigned beneficiary person years for other inpatient services in a short term acute care setting for assigned beneficiaries in the performance year. Inpatient claims are identified by claim type code 60integerlevel : Ratio
Outpatient_ExpendituresAnnualized, truncated, weighted mean expenditures per assigned beneficiary person years for outpatient services for assigned beneficiaries in the performance year. Includes all outpatient facility types including, but not limited to, hospital outpatient departments, outpatient dialysis facilities,integerlevel : Ratio
Physician_Supplier_ExpendituresAnnualized, truncated, weighted mean expenditures per assigned beneficiary person years for Part B physician/supplier (Carrier) services for assigned beneficiaries in the performance year. Includes all Part B physician/supplier services including, but not limited to, evaluation and management, procedures, imaging, laboratory and other test, Part B drugs, and ambulance services.integerlevel : Ratio
Ambulance_ExpendituresAnnualized, truncated, weighted mean expenditures per assigned beneficiary person years for ambulance services for assigned beneficiaries in the performance year. Ambulance services are identified in the Part B physician/supplier (Carrier) claims (claim type codes 71 and 72) by BETOS code O1Aintegerlevel : Ratio
Home_Health_ExpendituresAnnualized, truncated, weighted mean expenditures per assigned beneficiary person years for home health agency services for assigned beneficiaries in the performance year. Home health claims are identified by claim type code 10integerlevel : Ratio
Durable_Medical_Equipment_ExpendituresAnnualized, truncated, weighted mean expenditures per assigned beneficiary person years for durable medical equipment (DME) for assigned beneficiaries in the performance year. DME claims are identified by claim type codes 81 and 82integerlevel : Ratio
Inpatient_Hospital_DischargesTotal number of inpatient hospital discharges per 1,000 person-years in the performance year. A beneficiary is flagged for having a hospitalization if the beneficiary had at least one inpatient claim during the performance year. Each hospitalization is defined as a set of claims with the same Health Insurance Claim Number (HICNO), same admission date, and same provider number.numberlevel : Ratio
Short_Term_Acute_Care_Hospital_DischargesTotal number of short term acute care hospital discharges per 1,000 person-years in the performance year. A beneficiary is flagged for having a hospitalization in a short-term acute-care hospital if the beneficiary had at least one inpatient claim during the performance year.numberlevel : Ratio
LTCH_DischargesTotal number of long term care hospital (LTCH) discharges per 1,000 person-years in the performance year. A beneficiary is flagged for having a hospitalization in a long-term hospital if the beneficiary had at least one inpatient claim during the performance year.numberlevel : Ratio
IRF_DischargesTotal number of inpatient rehabilitation facility (IRF) discharges per 1,000 person-years in the performance year. A beneficiary is flagged for having a hospitalization in a rehabilitation hospital or unit if the beneficiary had at least one inpatient claim during the performance year.numberlevel : Ratio
IPF_DischargesTotal number of inpatient psychiatric facility (IPF) discharges per 1,000 person-years in the performance year. A beneficiary is flagged for having a hospitalization in a psychiatric hospital or unit if the beneficiary had at least one inpatient claim during the performance year.numberlevel : Ratio
CHF_DischargesTotal number of discharges for congestive heart failure (CHF) per 1,000 person-years in the performance year. Until 2015 Q4, measure specifications are based on AHRQ Prevention Quality Indicators Technical Specifications—Version 4.5. For 2015 Q4, ICD-10 codes CHF were derived from Measure Information Form (MIF) specifications.numberlevel : Ratio
COPD_Asthma_DischargesTotal Integer of discharges for chronic obstructive pulmonary disease (COPD) or asthma per 1,000 person-years in the performance year. Until 2015 Q4, measure specifications are based on AHRQ Prevention Quality Indicators Technical Specifications—Version 4.5. For 2015 Q4, ICD-10 codes for COPD/Asthma were derived from Version 5.0.numberlevel : Ratio
Bacterial_Pneumonia_DischargesTotal Integer of discharges for bacterial pneumonia per 1,000 person-years in the performance year. Until 2015 Q4, measure specifications are based on AHRQ Prevention Quality Indicators Technical Specifications—Version 4.5.numberlevel : Ratio
Short_Term_Acute_Care_ReadmissionsRate of short-term acute-care hospital readmissions within 30 days of discharge from a short-term acute-care hospital (including critical access hospitals) per 1,000 discharges among eligible beneficiaries assigned to the ACO in the performance year. When identifying an initial admission, all overlapping and contiguous hospital bills submitted to Medicare are considered as single hospital stays if there are no breaks greater than one day.numberlevel : Ratio
Post_Discharge_Provider_Visits_30_DayRate of provider visits within 30 days of discharge from a short-term acute-care hospital (including critical access hospitals) per 1,000 discharges among eligible beneficiaries assigned to the ACO in the performance year.numberlevel : Ratio
Skilled_Nursing_Facility_DischargesTotal number of discharges from a skilled nursing facility per 1,000 person-years in the performance year. Each SNF admission is defined as a set of claims with the same HICNO, same admission date, and same provider number.numberlevel : Ratio
Outpatient_ED_VisitsTotal number of visits to an outpatient emergency department (ED) per 1,000 person-years in the performance year. An Emergency Department Visit (EDV) is defined using both Inpatient & Outpatient claims and using the Revenue Center Code field on the claims.numberlevel : Ratio
Inpatient_ED_VisitsTotal number of visits to an emergency department (ED) that result in an inpatient stay per 1,000 person-years in the performance year. Emergency Department Visits that Lead to Hospitalizations is identified in the hospital inpatient claims with revenue center code values 0450-0459 and 0981numberlevel : Ratio
CT_EventsTotal number of computed tomography (CT) events per 1,000 person-years in the performance year. CT imaging events are defined based on BETOS codes I2A (advanced imaging-CAT: head) and I2B (advanced imaging-CAT: other)numberlevel : Ratio
MRI_EventsTotal number of magnetic resonance imaging (MRI) events per 1,000 person-years in the performance year. MRI imaging events are defined based on BETOS codes I2C (advanced imaging-MRI: brain) and I2D (advanced imaging-MRI: other)numberlevel : Ratio
Primary_Care_ServicesTotal number of primary care services per 1,000 person-years in the performance year. Primary care services are counted regardless of physician specialty. See Medicare Shared Savings Program Shared Savings and Losses and Assignment Methodology document for detail on the HCPCS and revenue center codes used to identify a primary care service visitnumberlevel : Ratio
Primary_Care_Services_With_A_PCPTotal number of primary care services provided by a primary care physician (PCP) per 1,000 person-years in the performance year. Defined as a qualifying visit with a primary care physician with a CMS specialty code of 1 (general practice), 8 (family practice), 11 (internal medicine), or 38 (geriatric medicine).numberlevel : Ratio
Primary_Care_Services_With_A_SpecialistTotal number of primary care services provided by a specialist per 1,000 person-years in the performance year. See Medicare Shared Savings Program Shared Savings and Losses and Assignment Methodology document for detail on the HCPCS and revenue center codes used to identify a primary care service visit and the specialty codes used to identify a physician specialistnumberlevel : Ratio
Primary_Care_Services_With_A_NP_PA_CNSTotal number of primary care services provided by a nurse practitioner (NP), physician's assistant (PA), or clinical nurse specialist (CNS) per 1,000 person-years in the performance year. Defined as a qualifying visit with practitioner with a CMS specialty code of 50 (nurse practitioner), 89 (clinical nurse specialist), and 97 (physician assistant).numberlevel : Ratio
Primary_Care_Services_With_A_FQHC_RHCTotal number of primary care services provided at a Federally Qualified Health Center (FQHC) or Rural Health Clinic (RHC) per 1,000 person-years in the performance year. See Medicare Shared Savings Program Shared Savings and Losses and Assignment Methodology document for detail on the HCPCS and revenue center codes used to identify a primary care service visitnumberlevel : Ratio
Number_of_CAH_IIsTotal number of Method II Critical Access Hospitals participating in the ACO in the performance year. Based on the ACO's certified participant list used in financial reconciliation and ACO-reported facility type.integerlevel : Ratio
Number_of_FQHCsTotal number of Federally Qualified Health Centers participating in the ACO in the performance year. Based on the ACO's certified participant list used in financial reconciliation and ACO-reported facility typeintegerlevel : Ratio
Number_of_RHCsTotal number of Rural Health Clinics participating in the ACO in the performance year. Based on the ACO's certified participant list used in financial reconciliation and ACO-reported facility typeintegerlevel : Ratio
Number_of_ETA_HospitalsTotal number of Electing Teaching Amendment Hospitals participating in the ACO in the performance year. Based on the ACO's certified participant list used in financial reconciliation and ACO-reported facility typeintegerlevel : Ratio
Number_of_Other_Facility_TypesTotal number of other facilities participating in the ACO in the performance year. Based on the ACO's certified participant list used in financial reconciliation and ACO-reported facility typeintegerlevel : Ratio
Number_of_Participating_PCPsTotal number of primary care physicians (PCPs) that reassigned billing rights to an ACO participant in the performance year. Based on the ACO's certified participant list used in financial reconciliation and information in the Medicare Provider Enrollment, Chain, and Ownership System (PECOS)integerlevel : Ratio
Number_of_Participating_SpecialistsTotal number of physician specialists that reassigned billing rights to an ACO participant in the performance year. Based on the ACO's certified participant list used in financial reconciliation and information in the Medicare Provider Enrollment, Chain, and Ownership System (PECOS)integerlevel : Ratio
Number_of_Participating_Nurse_PractitionersTotal number of nurse practitioners that reassigned billing rights to an ACO participant in the performance year. Based on the ACO's certified participant list used in financial reconciliation and information in the Medicare Provider Enrollment, Chain, and Ownership System (PECOS)integerlevel : Ratio
Number_of_Participating_Physician_AssistantsTotal number of physician assistants that reassigned billing rights to an ACO participant in the performance year. Based on the ACO's certified participant list used in financial reconciliation and information in the Medicare Provider Enrollment, Chain, and Ownership System (PECOS)integerlevel : Ratio
Number_of_Participating_Clinical_Nurse_SpecialistsTotal number of clinical nurse specialists that reassigned billing rights to an ACO participant in the performance year. Based on the ACO's certified participant list used in financial reconciliation and information in the Medicare Provider Enrollment, Chain, and Ownership System (PECOS)integerlevel : Ratio
ACO1Getting Timely Care, Appointments, and Informationnumberlevel : Ratio
ACO2How Well Your Providers Communicatenumberlevel : Ratio
ACO3Patients’ Rating of Providernumberlevel : Ratio
ACO4Access to Specialistsnumberlevel : Ratio
ACO5Health Promotion and Educationnumberlevel : Ratio
ACO6Shared Decision Makingnumberlevel : Ratio
ACO7Health Status/Functional Statusnumberlevel : Ratio
ACO8Risk Standardized, All Condition Readmissionnumberlevel : Ratio
ACO9Ambulatory Sensitive Condition Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI)numberlevel : Ratio
ACO10Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI)numberlevel : Ratio
ACO11Percent of PCPs who Successfully Meet Meaningful Use Requirementsnumberlevel : Ratio
ACO13Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period.numberlevel : Ratio
ACO14Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization.numberlevel : Ratio
ACO15Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine.numberlevel : Ratio
ACO16Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous six months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous six months of the current encounter.numberlevel : Ratio
ACO17Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received cessation counseling intervention if identified as a tobacco user.numberlevel : Ratio
ACO18Percentage of patients aged 12 years and older screened for clinical depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen.numberlevel : Ratio
ACO19Percentage of adults 50 - 75 years of age who had appropriate screening for colorectal cancer.numberlevel : Ratio
ACO20Percentage of women 50 through 74 years of age who had a mammogram to screen for breast cancer within 27 months.numberlevel : Ratio
ACO21Percentage of patients aged 18 years and older seen during the reporting period who were screened for high blood pressure AND a recommended follow-up plan is documented based on the current blood pressure (BP) reading as indicated.numberlevel : Ratio
ACO27Percentage of patients 18 - 75 years of age with diabetes who had hemoglobin A1c > 9.0% during the measurement period. Note that a lower performance rate is indicative of better quality.numberlevel : Ratio
ACO28Percentage of patients 18 - 85 years of age who had a diagnosis of hypertension and whose blood pressure was adequately controlled (< 140/90 mmHg) during the measurement period.numberlevel : Ratio
ACO30Percentage of patients 18 years of age and older who were discharged alive for acute myocardial infarction (AMI), coronary artery bypass graft (CABG) or percutaneous coronary interventions (PCI) in the 12 months prior to the measurement period, or who had an active diagnosis of ischemic vascular disease (IVD) during the measurement period, and who had documentation of use of aspirin or another antithrombotic during the measurement period.numberlevel : Ratio
ACO31Percentage of patients aged 18 years and older with a diagnosis of heart failure (HF) with a current or prior left ventricular ejection fraction (LVEF) < 40% who were prescribed beta-blocker therapy either within a 12 month period when seen in the outpatient setting OR at each hospital discharge.numberlevel : Ratio
ACO33Percentage of patients aged 18 years and older with a diagnosis of coronary artery disease seen within a 12 month period who also have diabetes OR a current or prior Left Ventricular Ejection Fraction (LVEF) < 40% who were prescribed ACE inhibitor or ARB therapy.numberlevel : Ratio
ACO34Stewardship of Patient Resourcesnumberlevel : Ratio
ACO35Risk-adjusted rate of all-cause, unplanned hospital readmissions within 30 days for ACO-assigned beneficiaries who had been admitted to a skilled nursing facility (SNF) after discharge from their prior proximal hospitalization. Note that a lower performance rate is indicative of better quality.numberlevel : Ratio
ACO36Rate of risk-standardized, acute, unplanned hospital admissions among beneficiaries 65 years and older with diabetes who are assigned or aligned to the ACO. Note that a lower performance rate is indicative of better quality.numberlevel : Ratio
ACO37Rate of risk-standardized, acute, unplanned hospital admissions among beneficiaries 65 years and older with heart failure who are assigned or aligned to the ACO. Note that a lower performance rate is indicative of better quality.numberlevel : Ratio
ACO38Rate of risk-standardized acute, unplanned hospital admissions among beneficiaries 65 years and older with MCCs who are assigned or aligned to the ACO. Note that a lower performance rate is indicative of better quality.numberlevel : Ratio
ACO39Percentage of visits for patients aged 18 years and older for which the eligible professional attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration.numberlevel : Ratio
ACO40Adult patients age 18 and older with major depression or dysthymia and an initial PHQ-9 score > 9 who demonstrate remission at twelve months defined as PHQ-9 score less than 5. This measure applies to both patients with newly diagnosed and existing depression whose current PHQ-9 score indicates a need for treatment.numberlevel : Ratio
ACO41Percentage of patients 18 - 75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period.numberlevel : Ratio
ACO42Percentage of the following patients—all considered at high risk of cardiovascular events—who were prescribed or were on statin therapy during the measurement period:numberlevel : Ratio
DM_CompPercentage of patients who meet the numerator criteria of ACO-41 and do not meet the numerator criteria of ACO-27.numberlevel : Ratio
ACO_YearACO_NumberACO_NameACO_StateStart_DateTotal_Assigned_BeneficiariesSaving_RateMin_Saving_PercentageBenchmark_Minus_ExpenditureGeneral_Save_LossEarned_Save_LossQuality_ScoreUpdated_Benchmark_ExpenditureHistory_BenchmarkTotal_Benchmark_ExpenditureTotal_ExpenditureAdvance_Payment_AmountAdvance_Payment_RecoupmentQuality_Performance_ShareFinal_Sharing_RatePer_Capita_Exp_All_ESRD_by_Year1Per_Capita_Exp_All_Disabled_by_Year1Per_Capita_Exp_All_AGDU_by_Year1Per_Capita_Exp_All_AGND_by_Year1Per_Capita_Exp_All_ESRD_by_Year2Per_Capita_Exp_All_Disabled_by_Year2Per_Capita_Exp_All_AGDU_by_Year2Per_Capita_Exp_All_AGND_by_Year2Per_Capita_Exp_All_ESRD_by_Year3Per_Capita_Exp_All_Disabled_by_Year3Per_Capita_Exp_All_AGDU_by_Year3Per_Capita_Exp_All_AGND_by_Year3Per_Capita_Exp_All_ESRD_Performance_YearPer_Capita_Exp_All_Disbled_Performance_YearPer_Capita_Exp_All_AGDU_Performance_YearPer_Capita_Exp_All_AGND_Performance_YearPer_Capita_Exp_Total_Performance_YearCMS_HCC_Risk_Score_ESRD_BY1CMS_HCC_Risk_Score_Disabled_BY1CMS_HCC_Risk_Score_AGDU_BY1CMS_HCC_Risk_Score_AGND_BY1CMS_HCC_Risk_Score_ESRD_BY2CMS_HCC_Risk_Score_DIS_BY2CMS_HCC_Risk_Score_AGDU_BY2CMS_HCC_Risk_Score_AGND_BY2CMS_HCC_Risk_Score_ESRD_BY3CMS_HCC_Risk_Score_DIS_BY3CMS_HCC_Risk_Score_AGDU_BY3CMS_HCC_Risk_Score_AGND_BY3CMS_HCC_Risk_Score_ESRD_Performance_YearCMS_HCC_Risk_Score_DIS_Performance_YearCMS_HCC_Risk_Score_AGDU_Performance_YearCMS_HCC_Risk_Score_AGND_Performance_YearESRD_Person_Years_in_Benchmark_Year3Disabled_Person_Years_in_Benchmark_Year3Aged_Dual_Person_Years_in_Benchmark_Year3Aged_Non_Dual_Person_Years_in_Benchmark_Year3Total_Person_Years_in_Performance_YearESRD_Person_Years_in_Performance_YearDisabled_Person_Years_in_Performance_YearAGED_DUAL_Person_Years_in_Performance_YearAGED_NON_DUAL_Person_Years_in_Performance_YearTotal_Assigned_Beneficiaries_Age_0_To_64Total_Assigned_Beneficiaries_Age_65_To_74Total_Assigned_Beneficiaries_Age_75_To_84Total_Assigned_Beneficiaries_Age_85_PlusTotal_Assigned_Beneficiaries_FemaleTotal_Assigned_Beneficiaries_MaleTotal_Assigned_Beneficiaries_Race_WhiteTotal_Assigned_Beneficiaries_Race_BlackTotal_Assigned_Beneficiaries_Race_AsianTotal_Assigned_Beneficiaries_Race_HispTotal_Assigned_Beneficiaries_Race_NativeTotal_Assigned_Beneficiaries_Race_OtherTotal_Inpatient_ExpendituresShort_Term_Care_Hospital_ExpenditureLong_Term_Care_Hospital_ExpenditureInpatient_Rehabilitation_Facility_ExpendituresInpatient_Psychiatric_Hospital_ExpendituresHospice_ExpendituresSkilled_Nursing_Facility_or_Unit_ExpendituresOther_Inpatient_ExpendituresOutpatient_ExpendituresPhysician_Supplier_ExpendituresAmbulance_ExpendituresHome_Health_ExpendituresDurable_Medical_Equipment_ExpendituresInpatient_Hospital_DischargesShort_Term_Acute_Care_Hospital_DischargesLTCH_DischargesIRF_DischargesIPF_DischargesCHF_DischargesCOPD_Asthma_DischargesBacterial_Pneumonia_DischargesShort_Term_Acute_Care_ReadmissionsPost_Discharge_Provider_Visits_30_DaySkilled_Nursing_Facility_DischargesOutpatient_ED_VisitsInpatient_ED_VisitsCT_EventsMRI_EventsPrimary_Care_ServicesPrimary_Care_Services_With_A_PCPPrimary_Care_Services_With_A_SpecialistPrimary_Care_Services_With_A_NP_PA_CNSPrimary_Care_Services_With_A_FQHC_RHCNumber_of_CAH_IIsNumber_of_FQHCsNumber_of_RHCsNumber_of_ETA_HospitalsNumber_of_Other_Facility_TypesNumber_of_Participating_PCPsNumber_of_Participating_SpecialistsNumber_of_Participating_Nurse_PractitionersNumber_of_Participating_Physician_AssistantsNumber_of_Participating_Clinical_Nurse_SpecialistsACO1ACO2ACO3ACO4ACO5ACO6ACO7ACO8ACO9ACO10ACO11ACO13ACO14ACO15ACO16ACO17ACO18ACO19ACO20ACO21ACO27ACO28ACO30ACO31ACO33ACO34ACO35ACO36ACO37ACO38ACO39ACO40ACO41ACO42DM_Comp
2015A50281Pricare ACO, LLCKentucky2015-01-0157192.773.68123540479867646446424724340706850507345480129765715260320721612086706064732742711157684081919776311422689877651.0951.0260.990.9440.9910.9690.9660.9620.980.9850.9580.9281.0461.0120.960.953438512514183559042830224449510392596152056432672452539922611557323772060462157112842616702505118441296265247211617981507864567418178424087504243335511292426481
2015A74254UPSA ACO LLCTexas2014-01-016570-1.013.49-61226992.269449900660540127611523975046.1378058981012233749677298950712010770777337945910948737870015939412714831095441.0421.1121.0050.9551.0351.1071.0020.9631.0931.1150.990.9711.0921.1261.1141.0198189044449136407907963435179107531771708610377527955538391903862163259819751703948633231341417389995813234274234525108761497503257716663628310431452653865041430
2015A79092ACONAAlabama2014-01-0172740.423.3531450191.38107231028175357979750434785045.69870937909147189535972678089142019639890988137154069555995228844140949994106781.0161.0161.1351.0461.1160.9941.0691.061.1110.9891.0921.0561.1381.0321.0971.0614913215025091702848129048352071528304019137934363291167664162081633617297917125824148010461423312727274936244539961624191613180753127804309737235861942253933438231612
2015A64316The PolyclinicWashington2012-07-018481-4.413.15-287102298.447862795165073370679443925049.2280425850911216622372705845487837001669077210858669256732498618777747782090.9371.1911.0370.9330.9431.1411.0250.9240.941.1370.920.9180.931.1590.9730.901102575208625182777848218575328304317223510994573390872973742871219492231722212450431344131676324567333195201195237331427673741011955332089953058479611338842372011
2015A07334Connected Care, LLCMichigan2015-01-018615-0.733.14-574103941892447876697479341077505080787920513099879065771966811306863178441880212594835062635939515076880094861.0961.131.1051.1281.0471.111.0621.1471.1361.1521.0731.1481.0671.1111.0921.14148172636364118364461665361629319733360224210404875374081992391023613830342835359590132545182532361144883073533331612925718282461778269626230954543164542667192284311
2015A79694PQN - Central Texas, LLCTexas2015-01-0164890.723.543315295249356601175365968438450506601310107931478966144998731013977056739611022130298182652281070514087830894550.9661.2711.1181.0760.9731.2621.1051.1170.9611.2341.1431.1430.9861.2541.1541.16103494113553063139648810156277782837201685837382751569158432806963076214712371936163283831481353981770240308252442597815571828680200881316871929414797978435143212
2015A25744PACNNorth Carolina2015-01-0115677-0.672.67-8732568456820412974706213062031850506665680511030973336261980381027374516125983489703762766951829611114784985131.0021.1081.1160.9830.9621.0481.0860.9780.9671.071.0450.9780.9441.0511.0290.9781331372554131251534413213845421328618587285464318918752692513570164549358928924732359298418225304169132977021831927526615414128146789366091978323731020539804687152612268123
2015A39151MD Valuecare, LLCVirginia2014-01-0115014-2.142.7-249068095.7795077251165116711190023515047.8572028859795317252672627828931373876575884479992698769199982011152752181200.9491.1220.9430.9351.0041.0981.0070.9230.9511.0640.9270.9210.9971.1441.030.9051049512031144414656999381501346915327699404617378936607812549203886164321260421671640429923731347312466432219264238214954128750335601666362529095400646194665435
2015A59192Franciscan Riverview Health ACOIndiana2015-01-0155481.683.7483184492068861494639684863212450507129610516115037880613448473132777985824931009115071819275716883913597844390511.0331.1021.0171.0080.9721.11910.9851.0121.1061.0070.9891.0861.131.0390.981315411414506537333567165460878126431502622317523735364552682932761222468451251638392013263686461271273241227311121513477768661150608254857839423783850328343521
2015A05496ASPA-ConnectedArizona, New Mexico2015-01-0146761.064.08409156849382153868109038271934505068500802794167030614596815956068757074775898949776461399830911077758684031.0371.0560.9380.9431.0261.0080.9570.9440.9840.9950.8390.9750.971.0410.8790.983527112203871455548647200366082620641295491246222143954114384273011328152190176421881443391438295110857828430426452312791016273937625198676259961448373873873312353832