J.) 177214 (Oxford Univ
Thus, consistent with the methodology that we apply in the case of advance investment payments, quarterly variations in an ACO's assignment list would translate to variations in the maximum quarterly total prepaid shared savings payments that an ACO may receive in any given quarter, in order to help ensure that the payments accurately reflect the attributes of the ACO's assigned beneficiary population throughout the current agreement period

For the second and each subsequent performance year during the term of the agreement period in which the ACO receives prepaid shared savings, the ACO's prepaid shared savings multiplier is recalculated for the following, as applicable: For the addition and removal of ACO participants or ACO providers/suppliers in accordance with 425.118(b), for a change to the ACO's beneficiary assignment methodology selection under 425.226(a)(1), for a change to the beneficiary assignment methodology specified in subpart E of this part, and for changes in per capita shared savings or losses for the performance years used in the calculation of the prepaid shared savings multiplier as a result of issuance of a revised initial determination under 425.315
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These values are multiplied by a conversion factor (CF) to convert the relative value units (RVUs) into payment rates