MSSP is an original Medicare incentive program created by CMS. This program is a voluntary program that encourages groups of doctors, hospitals, and other health care providers to come together as an ACO(Accountable Care Organization) to give coordinated, high quality care to their Medicare beneficiaries.By lowering healthcare costs for their assigned beneficiaries, ACO’s are eligible for a portion of those savings.
联邦医疗保险共享节省项目（MSSP）是联邦医疗保险和联邦医疗辅助计划服务中心（CMS）创建的初始医疗保险激励项目。该项目是自愿性的，它鼓励医生、医院和其他医疗服务提供者组成责任医疗组织（ACO），将高质量服务带给联邦医疗保险（Medicare）的受益人。若ACO降低了指定受益人的医疗费用，它将得到节省费用的一部分作为奖励。
Beneficiaries can be assigned in two ways. Patients can first Voluntarily Align themselves to an ACO by selecting an ACO provider as their primary physician through my.medicare.gov. All other beneficiaries are assigned by Claims Based Assignment, where patients are assigned to the ACO which provided the most primary care services (measured by Medicare-allowed charges). Regardless of how the beneficiary is assigned, he or she retains freedom of choice of providers inside and outside of the ACO.
受益人通过两种渠道被指派。首先，病人可以在网站my.medicare.gov通过选择ACO下属的医生作为主治医师来自愿挂靠ACO。其余受益人会通过问诊科目被指派，他们会被指派给向其提供最多基本医疗服务的ACO（由联邦医疗保险许可的费用衡量）。然而，无论通过何种方式，受益人依然拥有在ACO内外自由选择医生的权利。
The method of distribution amongst its providers is up to the individual ACO. CCACO retroactively assigns patients to doctors first based on the primary care physician who performed the last Annual Wellness Visit and then based on most number of visits with a provider in the previous years.
将受益人在医生中分配的方法由ACO自行决定。CCACO使用回溯的方式。首先，判定哪一位主治医师负责了受益人的最近一次年度健康访问。第二，病人在过去向哪位医生问诊次数最多。
CMS first considers Primary Care Provider for beneficiary assignment. CMS defines the following specialties to be Primary Care Provider: Internal Medicine, Family Medicine, Geriatric Medicine, Pediatric Medicine, General Practice, Nurse Practitioners, Physician Assistants;
For beneficiaries that have not visited any Primary Care Provider, CMS uses the following specialties for assignment: Cardiology, Osteopathic Manipulation, Neurology, OB/GYN, Sports Medicine, Physical Medicine and Rehabilitation, Psychiatry, General Psychiatry, Pulmonary Disease, Nephrology, Endocrinology, Multispecialty clinic or group practice, Hematology, Hematology/Oncology, Preventive Medicine, Neuropsychiatry, Medical Oncology, Gynecology Oncology
进行受益人分配时，CMS首先考虑主治医师。CMS将在以下领域执业（或拥有该头衔）的医生（或人员）定义为主治医师：内科、家庭科、老年科、儿科、全科、执业护士、医师助理。如果受益人没有访问过主治医师，CMS会考虑以下领域作为分配标准：心脏病学、整骨、神经内科、妇产科、运动医学、复健医学、精神病学、一般精神病学、肺疾病、肾脏病学、内分泌、综合学科、血液学、血液学/肿瘤科、预防医学、神经精神医学、内科肿瘤科、妇产科肿瘤科
These are Original Medicare Patients that have visited your practice in the past year, but are not assigned to our ACO because we did provide plurality of service (see above). By bringing them in for services such as Annual Wellness Visits or having them Voluntarily Align by selecting you as their primary doctor, we may be able to add them to our patient panel.
他们是去年访问过你的诊所的初始联邦医疗保险病人，却因为我们未向其提供多种服务（见上方）而没被指派给ACO。通过对他们进行年度健康访问或者让他们选择你作为主治医师，我们可将他们加入进病患名单。
Since MSSP only governs Original Medicare patients, ACO participation will not affect any plans involving Medicaid HMO, Medicare Advantage, or commercial insurances.
MSSP只覆盖初始联邦医疗保险病人。参与ACO不会影响Medicaid HMO、Medicare Advantage或商业保险。
ACO participation occurs at TIN level. Any TIN that bills primary care services to Medicare may only join one ACO. TINs that do not bill primary care services may join multiple ACOs. Individual providers may participate in multiple ACOs given that they bill under multiple TINs that are participants of different ACOs.
“加入ACO”这一举动发生在纳税人（TIN）级别。任何向联邦医疗保险出具基本医疗服务账单的TIN只能加入一个ACO。如果没有出具该账单，则可以加入多个ACO。医生个人能加入多个ACO，因为他们可能在多个从属于ACO的TIN下出具了账单。
CMS denotes the following CPT/HCPCS codes as primary care services: 96160-96161, 99201–99205, 99211–99215, 99304–99306, 99307–99310, 99315–99316, 99318, 99324–99328, 99334–99337, 99339–99340, 99341–99345, 99347–99350, 99354-99355, 99484, 99487, 99489, 99490, 99492-99494, 99495–99496, 99497-99498, G0402, G0438, G0439, G0442-G0444, G0463 (for ETA hospitals), and G0506.
CMS将以下CPT/HCPCS代码指代的项目界定为初级医疗服务：96160-96161, 99201–99205, 99211–99215, 99304–99306, 99307–99310, 99315–99316, 99318, 99324–99328, 99334–99337, 99339–99340, 99341–99345, 99347–99350, 99354-99355, 99484, 99487, 99489, 99490, 99492-99494, 99495–99496, 99497-99498, G0402, G0438, G0439, G0442-G0444, G0463 (for ETA hospitals), and G0506
SOMOS ACO was formed by CCACO and Balance ACO. CCACO is the #3 ACO in NYS, earning $2mm in shared savings incentives in 2017. Balance ACO is the #1 ACO in NYS, earning $13mm in shared savings incentive in 2017. CCACO has historically participated in the Track 1 Model (upside, shared savings only). CCACO and Balance ACO are preparing to continue participation in the MSSP as SOMOS ACO in the Track 3/Enhanced Model (upside savings/ downside risk sharing). Potential downside risk will be taken on by the organization, not the individual provider.
SOMOS ACO由CCACO和Balance ACO组成。CCACO是纽约州第三个责任医疗组织，2017年取得200万美元的共享节省激励。Balance ACO是纽约州第一个责任医疗组织，2017年赚取1300万美元。CCACO过去参与的是“模式一”（共享节省）。CCACO和Balance ACO合并成SOMOS ACO后，计划参与进联邦医疗保险共享节省项目的“模式三”（共享节省和共享风险）。潜在的风险会由组织而非医生个人承担。
Yes, you will continue to remain a CCACO member, but to continue your participation in the Medicare Shared Savings Program, you must sign a PPA with SOMOS ACO. You will participate in the MSSP through SOMOS ACO as a CCACO member.
是，你会维持CCACO会员身份，但是为了继续参与进联邦医疗保险共享节省项目（MSSP），你必须与SOMOS ACO签署一份PPA。你会作为CCACO会员，通过SOMOS ACO参与MSSP。
You will receive the benefits of MSSP participation, such as receiving shared savings incentives, 5% increase in Medicare payments, exemption from reporting requirements, and potential participation in beneficiary incentive programs. You will lose these benefits if you do not sign a PPA with SOMOS ACO.
你会收到MSSP参与奖励，例如共享节省激励、Medicare项目费用额外5%的分红，MIPS汇报豁免和预备加入受益人激励项目。如果你不与SOMOS ACO签署PPA，你会失去这些优惠。
Yes. As a participant in SOMOS ACO, you are supported by a team of MACRA experts who will help you successfully meet all requirements. You will be joining a team that has consistently achieved high quality scores.
是。作为SOMOS ACO参与者，MACRA的法律专家们会帮助你顺利达成所有目标。你加入的团队自始至终都在质量指标上有着优异表现。
The risk scores displayed on the dashboard is based on the CMS-HCC model for risk adjustment. The model predicts patient expenditure based on the diagnosis codes that were coded in the previous year and is used by CMS to determine benchmarks for Medicare Advantage. It is also a component of our ACO benchmark, thus it is important for providers to properly code to ensure their patients receive the correct risk adjustment.
面板上呈现的风险指标基于的是用于风险调节的CMS-HCC模型。模型使用病人过往的诊断码来预测他们的花费，并被CMS用于决定Medicare Advantage的标准值。它同时也是ACO标准值的组成部分。因此，医生必须正确记录病人数据，确保他们受到正确的风险调节。
Dropped off codes are ICD codes that were coded in the previous calendar year but have not been coded this year. If the codes are still medically appropriate, they should still be coded even if the office visit is not for that particular condition. For example, a patient with a disability (e.g amputation) should have the ICD coded every year.
遗落代码是去年记录但今年未被记录的ICD代码。如果代码在医学范畴内合适，即便病人问诊不是为了特定病症而去，该病症的代码也应记录在案。例如，一位残疾病人（如截肢）每年都应记录相应的ICD代码。