For nearly two decades, Better Health Group has been a leader in value-based care and operating top-rated primary care clinics. Our network of owned and independent clinics leverage our model to improve care for both Medicare Advantage (MA) and Traditional Medicare patients. Now, the Centers for Medicare & Medicaid Services (CMS) has ranked Better Health Group in the top 5% of Medicare Shared Savings Program (MSSP), Accountable Care Organizations (ACOs) for performance year 2023.
At a time when independent clinics face mounting challenges, our providers are exceeding CMS quality goals and maximizing shared savings revenue, in every state in which we operate—Florida, Alabama, Georgia, Texas, Oklahoma, and Tennessee.
What Is Patient Attribution?
Patient attribution (also called beneficiary assignment) is the process CMS uses to determine which Accountable Care Organization (ACO) is responsible for, and financially accountable for, a given Medicare patient's total cost of care. It's a foundational concept in the Medicare Shared Savings Program (MSSP): an ACO can only earn shared savings on patients who are attributed to it.
Attribution isn't something a patient signs up for. It happens automatically, based on claims data, which means a practice's patients can be attributed to an ACO the practice has never heard of.
How Does CMS Decide Attribution?
CMS primarily attributes patients based on where they receive the plurality of their primary care services, measured by allowed charges for primary care visits over a defined lookback period. In practical terms: if a patient sees their primary care physician more than any other provider for primary-care-billable services, and that physician participates in an ACO, the patient is very likely to be attributed to that ACO.
This is why attribution methodology matters so much to independent primary care physicians specifically. Specialists and hospitalists rarely drive attribution; primary care does.
Why This Matters If You're Not in an ACO
Here's the part many independent physicians miss: your patients may already be attributed to an ACO, just not yours. If you're seeing Medicare fee-for-service patients and you're not participating in an MSSP ACO, any shared savings your care is generating are likely flowing to a competitor's ACO, or nowhere at all if your patients aren't attributed anywhere. You're doing the clinical work of value-based care without capturing any of its financial upside.
What's Changing
The direction of travel is toward tightening attribution rules in ways that reward ACO participation and reduce ambiguity about where a patient's care is credited.
What This Means for Independent Practices
If your patients are already being attributed somewhere based on the care you're providing, joining an ACO doesn't create a new administrative burden so much as it captures value that's currently being generated and given away. Understanding your own attribution status, whether your patients are currently assigned to any ACO, is a useful first step before deciding whether to join one.
FAQ
- Do patients choose their ACO? No. Attribution is determined automatically by CMS based on claims data and where the patient receives the plurality of their primary care.
- Can a patient be attributed to more than one ACO? No. A given patient can only be attributed to one ACO per performance year.
- How many beneficiaries does an ACO need to participate in MSSP? Generally, an ACO needs at least 5,000 assigned Medicare beneficiaries to participate, which is why most independent practices join an existing ACO rather than forming a new one.
Related reading: Better Health Group, What Is the Medicare Shared Savings Program?
What Is Patient Attribution?
Patient attribution (also called beneficiary assignment) is the process CMS uses to determine which Accountable Care Organization (ACO) is responsible for, and financially accountable for, a given Medicare patient's total cost of care. It's a foundational concept in the Medicare Shared Savings Program (MSSP): an ACO can only earn shared savings on patients who are attributed to it.
Attribution isn't something a patient signs up for. It happens automatically, based on claims data, which means a practice's patients can be attributed to an ACO the practice has never heard of.
How Does CMS Decide Attribution?
CMS primarily attributes patients based on where they receive the plurality of their primary care services, measured by allowed charges for primary care visits over a defined lookback period. In practical terms: if a patient sees their primary care physician more than any other provider for primary-care-billable services, and that physician participates in an ACO, the patient is very likely to be attributed to that ACO.
This is why attribution methodology matters so much to independent primary care physicians specifically. Specialists and hospitalists rarely drive attribution; primary care does.
Why This Matters If You're Not in an ACO
Here's the part many independent physicians miss: your patients may already be attributed to an ACO, just not yours. If you're seeing Medicare fee-for-service patients and you're not participating in an MSSP ACO, any shared savings your care is generating are likely flowing to a competitor's ACO, or nowhere at all if your patients aren't attributed anywhere. You're doing the clinical work of value-based care without capturing any of its financial upside.
What's Changing
The direction of travel is toward tightening attribution rules in ways that reward ACO participation and reduce ambiguity about where a patient's care is credited.
What This Means for Independent Practices
If your patients are already being attributed somewhere based on the care you're providing, joining an ACO doesn't create a new administrative burden so much as it captures value that's currently being generated and given away. Understanding your own attribution status, whether your patients are currently assigned to any ACO, is a useful first step before deciding whether to join one.
FAQ
- Do patients choose their ACO? No. Attribution is determined automatically by CMS based on claims data and where the patient receives the plurality of their primary care.
- Can a patient be attributed to more than one ACO? No. A given patient can only be attributed to one ACO per performance year.
- How many beneficiaries does an ACO need to participate in MSSP? Generally, an ACO needs at least 5,000 assigned Medicare beneficiaries to participate, which is why most independent practices join an existing ACO rather than forming a new one.
Related reading: Better Health Group, What Is the Medicare Shared Savings Program?
What Is Patient Attribution?
Patient attribution (also called beneficiary assignment) is the process CMS uses to determine which Accountable Care Organization (ACO) is responsible for, and financially accountable for, a given Medicare patient's total cost of care. It's a foundational concept in the Medicare Shared Savings Program (MSSP): an ACO can only earn shared savings on patients who are attributed to it.
Attribution isn't something a patient signs up for. It happens automatically, based on claims data, which means a practice's patients can be attributed to an ACO the practice has never heard of.
How Does CMS Decide Attribution?
CMS primarily attributes patients based on where they receive the plurality of their primary care services, measured by allowed charges for primary care visits over a defined lookback period. In practical terms: if a patient sees their primary care physician more than any other provider for primary-care-billable services, and that physician participates in an ACO, the patient is very likely to be attributed to that ACO.
This is why attribution methodology matters so much to independent primary care physicians specifically. Specialists and hospitalists rarely drive attribution; primary care does.
Why This Matters If You're Not in an ACO
Here's the part many independent physicians miss: your patients may already be attributed to an ACO, just not yours. If you're seeing Medicare fee-for-service patients and you're not participating in an MSSP ACO, any shared savings your care is generating are likely flowing to a competitor's ACO, or nowhere at all if your patients aren't attributed anywhere. You're doing the clinical work of value-based care without capturing any of its financial upside.
What's Changing
The direction of travel is toward tightening attribution rules in ways that reward ACO participation and reduce ambiguity about where a patient's care is credited.
What This Means for Independent Practices
If your patients are already being attributed somewhere based on the care you're providing, joining an ACO doesn't create a new administrative burden so much as it captures value that's currently being generated and given away. Understanding your own attribution status, whether your patients are currently assigned to any ACO, is a useful first step before deciding whether to join one.
FAQ
- Do patients choose their ACO? No. Attribution is determined automatically by CMS based on claims data and where the patient receives the plurality of their primary care.
- Can a patient be attributed to more than one ACO? No. A given patient can only be attributed to one ACO per performance year.
- How many beneficiaries does an ACO need to participate in MSSP? Generally, an ACO needs at least 5,000 assigned Medicare beneficiaries to participate, which is why most independent practices join an existing ACO rather than forming a new one.
Related reading: Better Health Group, What Is the Medicare Shared Savings Program?