MSSP ACOs Data Tools Overview

The Medicare Shared Savings Program (MSSP) is a CMS program that allows groups of healthcare providers to form Accountable Care Organizations (ACOs) and share in savings generated by delivering higher-quality, lower-cost care to Medicare beneficiaries.

The Tuva Project provides a suite of tools specifically designed for MSSP ACO organizations to access, transform, and analyze their CMS data. This section documents four components that form an end-to-end claims analytics pipeline, and one standalone tool for calculating benchmark savings calculations.

Components

Claims Analytics Pipeline

These components work together sequentially to load raw CMS data into the Tuva Project and produce MSSP-specific analytics:

Component	Type	Purpose
MSSP Pipeline	Python CLI	Downloads MSSP ACO files from the CMS Datahub and loads them into your data warehouse
CMS MSSP Connector	dbt project	Transforms remaining MSSP report files (BEUR, BAIP, NCBP, MCQM, EXPU, Shadow Bundles, etc.) into data marts
CMS ALR Connector	dbt project	Transforms CMS Assignment List Reports (ALR) into the enrollment format required by the CCLF connector, and creates the attribution input format based on data in the ALRs
Medicare CCLF Connector	dbt project	Transforms CMS Comprehensive Claims and Line Feed (CCLF) files into the Tuva Input Layer and combines with ALR data, then runs the Tuva dbt project to create enriched claims datamarts
CMS ACO Dashboards	Power BI Dashboard	Suite of dashboards that allow a MSSP ACO to understand their attributed population, cost & utilzation, and risk adjustment / quality measure performance

Claims Analytics Data Flow

The pipeline components run in the following order:

What CMS Data Is Involved

MSSP ACO organizations receive several types of files from CMS through the Datahub portal:

• CCLF (Comprehensive Claims and Line Feed) — Medicare Parts A, B, and D claims for assigned beneficiaries, plus beneficiary demographic and MBI cross-reference files. This is the primary claims dataset used for cost and quality analytics.

• ALR (Assignment List Report) — Quarterly reports identifying which beneficiaries are assigned to your ACO. Contains enrollment flags, voluntary alignment designations, and underserved beneficiary indicators.

• Other MSSP Reports and Files — Additional reports/files including:

  • Beneficiary Advanced Investment Payment Report (BAIP)
  • Aggregate Expenditure/Utilization Report (EXPU)
  • Beneficiary Expenditure/Utilization Report (BEUR)
  • Non-Claims Based Payment (NCBP)
  • quality metrics population (MCQM)
  • Participants List
  • Provider and Supplier List
  • Shadow Bundle reports

Getting Started

See the Getting Started guide for step-by-step instructions on setting up and running the full pipeline.