Commitment to Enhanced Financial Support for Participating Primary Sample Clauses

Commitment to Enhanced Financial Support for Participating Primary. Care Practices 1. Non-Visit-Based Financial Support

Commitment to Enhanced Financial Support for Participating Primary. Care Practices 1. [PAYER] will provide the level and method of enhanced, non-visit-based financial support to participating primary care practices set out in Appendix 1. [PAYER] has designed this support to allow participating primary care practices to invest in the infrastructure, staffing, education and training necessary for delivery of the five comprehensive primary care functions outlined in the Solicitation. 2. The Innovation Center will provide participating primary care practices with an average $20 per- beneficiary-per-month care management payment on behalf of Medicare fee-for-service beneficiaries, in addition to their traditional fee-for-service payments. These care management payments will range from $8 to $40 and will be risk-adjusted based on the hierarchical condition category (HCC) risk score that CMS has calculated for each beneficiary. In Years 3 and 4 of the initiative, the Innovation Center’s care management payment will be reduced to an average of $15, adjusted for respective reduction in the risk tiers, to reflect efficiencies gained and to help shift support to accountable forms of payment. 3. The Effective Market Start Date is the beginning of the accrual of payment commitments. [PAYER] and the Innovation Center will each provide participating primary care practices with their first monthly non-visit-based care management payment no later than 60 days after the Effective Market Start Date of [MARKET START DATE]. 4. No later than 24 months after the start of the initiative, [PAYER] and the Innovation Center will each begin offering participating primary care practices opportunities to share a portion of any savings achieved during the previous performance period through the delivery of high quality and efficient health care. [PAYER] and the Innovation Center will each provide participating primary care practices with reasonable notice and information about their proposed shared savings methodologies. 5. Where applicable, [PAYER] will include the Administrative Services Only (ASO) lives it committed to in its application to CMS in this initiative. After [PAYER] has signed this MOU, [PAYER] will use best efforts to bring as many members as possible from its ASO lines of business into this initiative, including through (but not limited to) undertaking outreach to its ASO customers in [MARKET] to explain the value of participation.