§ 512.715 Overview of performance assessment.
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Title 42—Public Health > CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES > SUBCHAPTER H—HEALTH CARE INFRASTRUCTURE AND MODEL PROGRAMS > PART 512—STANDARD PROVISIONS FOR MANDATORY INNOVATION CENTER MODELS AND SPECIFIC PROVISIONS FOR CERTAIN MODELS > Subpart G—Ambulatory Specialty Model (ASM) > Performance Categories and Scoring
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(a) General. As further described in §§ 512.725, 512.730, 512.735, and 512.740:
(1) An ASM participant receives a specific number of points for its performance on each measure or activity within an ASM performance category.
(2) CMS assigns the total amount of points an ASM participant may receive for its performance on a measure or activity.
(3) CMS calculates a final score as described at § 512.745 using the points received across all four ASM performance categories.
(b) Data sources. (1) CMS uses Medicare claims data and Medicare administrative data reported to calculate measure scores included in the quality and cost ASM performance categories under §§ 512.725 and 512.730.
(2) CMS uses model-specific data reported under § 512.720 to calculate applicable measure or activity scores for the quality, improvement activities, and Promoting Interoperability ASM performance categories under §§ 512.725, 512.735, and 512.740.
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