Payment fluctuations can happen from month to month when patients switch to a Medicare Advantage plan, relocate out of the service area, or are no longer living. Patients that opt out of data sharing revert back to FFS payments. Sometimes there are delays in Medicare providing us this information, hence the adjustments. Payments may also change if patients are changed from an A&D patient to an ESRD patient. Below is a sample payment statement:

Payments received for now un-aligned patients in prior months will be offset which may result in slightly lower overall payments (e.g. we learn in March that a patient moved in January. The March payment will debit the February payment and cease paying). On the contrary, information about additions may result in higher payments for the month (e.g. we learn in May that a patient was added in April- in May we will pay for both April and May).

Voluntary alignment will be updated quarterly which will likely result in higher overall payments for participating practices as patient volume increases.