TIN Splitting

TIN Splitting is rapidly becoming one of the most powerful strategies in the value-based care ecosystem—yet few ACOs execute it correctly. Done well, it gives ACOs precision control over costs, RAF, and patient attribution.

Metacare specializes in high-ROI TIN Splitting deployments, enabling ACOs to segment patient populations, improve risk adjustment accuracy, and boost shared savings by millions.

The #1 Thing You Can Do for Your ACO Today

What is TIN Splitting?

TIN Splitting is the process of creating one or more additional Tax Identification Numbers (TINs) so that an organization can segment providers or patient populations under separate billing entities.

This is primarily used in value-based care models such as
→ Accountable Care Organizations (ACOs)
→ Medicare Shared Savings Program (MSSP)
→ ACO REACH
→ IPAs, MSOs, CINs, LTC ACOs

TIN Splitting reshapes attribution and reshapes performance scores, allowing ACOs to isolate:

High-performing vs low-performing practices
Long-Term Care (LTC) vs Community populations
Hospital-based vs office-based clinicians
Specialty or geographic segmentation

Example

A multi-state ACO with 400 PCPs may separate LTC providers into a new TIN to avoid diluting performance and risk scores with community-based patient data.

Why ACOs Use TIN Splitting

Strategic Advantage	Impact
Improves RAF & risk adjustment scoring	+0.2–0.5 RAF uplift = millions in revenue
Better contract leverage with payors & ACOs	Improved upside + reduced downside risk
Controls high-cost populations	Removes distortion from LTC, SNF, or complex cohorts
Accelerates Shared Savings performance	30–80%+ improvement in year-one performance
Reduce CMS Audit Risk	Practices own and bill under their own TIN instead of your corporate TIN

Pros & Cons of TIN Splitting

Pros (Why ACOs Love It)

Major boost in Shared Savings (often +$2M–$20M per year)
Creates aligned incentive structures
Cleaner attribution = clearer accountability
Attracts top practices who want performance protection
Enables flexible contracting with payors & REACH/DCE entities
Reduced downside risk exposure
Reduced CMS audit risk

Cons (If Done Without Expertise)

Credentialing, NPI/NPPES & PECOS complexity
Risk of delays if incorrect sequencing occurs
Bifurcated TIN billing confusion for billing teams & payors
Must be executed before attribution deadlines

The 7 Components of a Successful TIN Split

Strategic Segmentation Blueprint
Attribution & population modeling to determine ideal TIN structure
New TIN Formation & Compliance Setup
NPI Registration & Type-2 Linking
PECOS Enrollment & Provider Reassignment
Payer Contracting & Credentialing
Data Migration, Billing & RCM Setup
ACO Notification & Performance Monitoring

Metacare completes the process in under 45 days, the fastest in the industry.

The #1 mistake ACOs make is waiting until Q2 to consider TIN Splitting

Why ACOs Choose Metacare

Metacare is widely regarded as the #1 TIN Splitting partner for ACOs because we combine:

Fastest PECOS approval in the U.S. (<30 days average)
Expertise across all 50 states (including CPOM-restricted states)
AI-powered risk adjustment tools to boost RAF post-split
White-glove, concierge implementation so practices never feel burdened

Metacare often structures partnership pricing that costs the ACO $0 out-of-pocket.

Download our free TIN Splitting checklist today.

Guidance on the minimum required documents to initiate TIN Splitting for practices.

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