We use cookies on our site to analyze traffic, enhance your experience, and provide you with tailored content.

For more information visit our privacy policy.

Common use of Other Adjustments Clause in Contracts

Other Adjustments. a. The HSCRC and the Hospital recognize that some services may be offered more effectively in an unregulated setting. When services covered by the GBR model are moved to an unregulated setting, the HSCRC staff will calculate and apply a reduction to the Hospital's Approved Regulated Revenue. At a minimum, the reduction will ensure that the shift provides a savings to the public and Medicare after taking into consideration the payment amounts likely to be made for the same services in an unregulated setting. b. The HSCRC may initiate a review, or the Hospital may request, an adjustment to the Hospital's Approved Regulated Revenue to reflect changes in the market share of the Hospital. The HSCRC staff and the relevant Work Group(s) will be engaged during CY 2014 (and thereafter) in efforts to develop and refine rate setting policies to appropriately adjust for the impact of market share changes. These policies will be designed to separate the impact of reductions in avoidable volumes and volume increases, to the extent possible, from market share changes. c. The HSCRC staff will work with the Hospital and with other hospitals that adopt the GBR model to calculate and evaluate any volume increases experienced by the Hospital and other hospitals that are induced by the expansion of health care coverage under the Affordable Care Act (“ACA”) in 2014 and 2015, for insured populations under the age of 65, net of reductions in volumes for uninsured populations. Based on the 3 For SFY 2014 through 2018, the Hospital will be subject to a Readmission Policy Adjustment. findings of this evaluation, the HSCRC staff may provide a one-time adjustment to the Hospital's Approved Regulated Revenue.4 d. The HSCRC staff will consider one-time adjustments to the Hospital’s regulated revenue for unanticipated events beyond the control of the Hospital that generate substantial increases in the Hospital’s utilization levels, but only to the extent that the impact of such events on the Hospital materially and demonstrably exceeds the impact of similar events on other hospitals covered by the GBR model. In summary, the GBR model is a new approach to hospital rate regulation in Maryland. The HSCRC and the Hospital agree to work together to address any significant unforeseen consequences of this Agreement to ensure that it meets the revenue constraints, savings targets and performance improvement requirements required by the final contract between CMMI and the State of Maryland.

Appears in 8 contracts

Samples: Global Budget Revenue Agreement, Global Budget Revenue Agreement, Global Budget Revenue Agreement

Other Adjustments. a. The HSCRC and the Hospital recognize that some services may be offered more effectively in an unregulated setting. When services covered by the GBR model are moved to an unregulated setting, the HSCRC staff will calculate and apply a reduction to the Hospital's Approved Regulated Revenue. At a minimum, the reduction will ensure that the shift provides a savings to the public and Medicare after taking into consideration the payment amounts likely to be made for the same services in an unregulated setting. b. The HSCRC may initiate a review, or the Hospital may request, an adjustment to the Hospital's Approved Regulated Revenue to reflect changes in the market share of the Hospital. The HSCRC staff and the relevant Work Group(s) will be engaged during CY 2014 (and thereafter) in efforts to develop and refine rate setting policies to appropriately adjust for the impact of market share changes. These policies will be designed to separate the impact of reductions in avoidable volumes and volume increases, to the extent possible, from market share changes. c. The HSCRC staff will work with the Hospital and with other hospitals that adopt the GBR model to calculate and evaluate any volume increases experienced by the Hospital and other hospitals that are induced by the expansion of health care coverage under the Affordable Care Act (“ACA”) in 2014 and 2015, for insured populations under the age of 65, net of reductions in volumes for uninsured populations. Based on the 3 For SFY 2014 through 2018, the Hospital will be subject to a Readmission Policy Adjustment. findings of this evaluation, the HSCRC staff may provide a one-time adjustment to the Hospital's Approved Regulated Revenue.4 d. The HSCRC staff will consider one-time adjustments to the Hospital’s regulated revenue for unanticipated events beyond the control of the Hospital that generate substantial increases in the Hospital’s utilization levels, levels but only to the extent that the impact of such events on the Hospital materially and demonstrably exceeds the impact of similar events on other hospitals covered by the GBR model. In summary, the GBR model is a new approach to hospital rate regulation in Maryland. The HSCRC and the Hospital agree to work together to address any significant unforeseen consequences of this Agreement to ensure that it meets the revenue constraints, savings targets and performance improvement requirements required by the final contract between CMMI and the State of Maryland.

Appears in 4 contracts

Samples: Global Budget Revenue Agreement, Global Budget Revenue Agreement, Global Budget Revenue Agreement

Other Adjustments. a. The HSCRC and the Hospital recognize that some services may be offered more effectively in an unregulated setting. When services covered by the GBR model are moved to an unregulated setting, the HSCRC staff will calculate and apply a reduction to the Hospital's Approved Regulated Revenue. At a minimum, the reduction will ensure that the shift provides a savings to the public and Medicare after taking into consideration the payment amounts likely to be made for the same services in an unregulated setting. b. The HSCRC may initiate a review, or the Hospital System, on behalf of any Hospital may request, request an adjustment to the Hospital's Approved Regulated Revenue to reflect changes in the market share of the that Hospital. The HSCRC staff and the relevant Work Group(s) will be engaged during CY 2014 (and thereafter) in efforts to develop and refine rate setting policies to appropriately adjust for the impact of market share changes. These policies will be designed to separate the impact of reductions in avoidable volumes and volume increases, to the extent possible, from market share changes. c. The HSCRC staff will work with the Hospital and with other hospitals that adopt the GBR model to calculate and evaluate any volume increases experienced by the Hospital 2 Health Care Coverage Fund, MHIP, Deficit Assessment, HSCRC and MHCC user fees, NSP, and CRISP are examples of such assessments currently in place and are subject to change by the Commission. 3 For SFY 2014 through 2018, the Hospital will be subject to a Readmission Policy Adjustment. and other hospitals that are induced by the expansion of health care coverage under the Affordable Care Act (“ACA”) in 2014 and 2015, for insured populations under the age of 65, net of reductions in volumes for uninsured populations. Based on the 3 For SFY 2014 through 2018, the Hospital will be subject to a Readmission Policy Adjustment. findings of this evaluation, the HSCRC staff may provide a one-time adjustment to the Hospital's Approved Regulated Revenue.4 d. The HSCRC staff will consider one-time adjustments to the Hospital’s regulated revenue for unanticipated events beyond the control of the Hospital that generate substantial increases in the Hospital’s utilization levels, levels but only to the extent that the impact of such events on the Hospital materially and demonstrably exceeds the impact of similar events on other hospitals covered by the GBR model. In summary, the GBR model is a new approach to hospital rate regulation in Maryland. The HSCRC and Hospital System, on behalf of the Hospital Hospitals agree to work together to address any significant unforeseen consequences of this Agreement to ensure that it meets the revenue constraints, savings targets and performance improvement requirements required by the final contract between CMMI and the State of Maryland.

Appears in 3 contracts

Samples: Global Budget Revenue Agreement, Global Budget Revenue Agreement, Global Budget Revenue Agreement

Other Adjustments. a. The HSCRC and the Hospital MedStar recognize that some services may be offered more effectively in an unregulated setting. When services covered by the GBR model are moved to an unregulated setting, the HSCRC staff will calculate and apply a reduction to the Hospital's Approved Regulated Revenue. At a minimum, the reduction will ensure that the shift provides a savings to the public and Medicare after taking into consideration the payment amounts likely to be made for the same services in an unregulated setting. b. The HSCRC may initiate a review, or the MedStar on behalf of any Hospital may request, request an adjustment to the Hospital's Approved Regulated Revenue to reflect changes in the market share of the that Hospital. The HSCRC staff and the relevant Work Group(s) will be engaged during CY 2014 (and thereafter) in efforts to develop and refine rate setting policies to appropriately adjust for the impact of market share changes. These policies will be designed to separate the impact of reductions in avoidable volumes and volume increases, to the extent possible, from market share changes. 2 Health Care Coverage Fund, MHIP, Deficit Assessment, HSCRC and MHCC user fees, NSP, and CRISP are examples of such assessments currently in place and are subject to change by the Commission. 3 For SFY 2014 through 2018, the Hospital will be subject to a Readmission Policy Adjustment. c. The HSCRC staff will work with the Hospital and with other hospitals that adopt the GBR model to calculate and evaluate any volume increases experienced by the Hospital and other hospitals that are induced by the expansion of health care coverage under the Affordable Care Act (“ACA”) in 2014 and 2015, for insured populations under the age of 65, net of reductions in volumes for uninsured populations. Based on the 3 For SFY 2014 through 2018, the Hospital will be subject to a Readmission Policy Adjustment. findings of this evaluation, the HSCRC staff may provide a one-time adjustment to the Hospital's Approved Regulated Revenue.4 d. The HSCRC staff will consider one-time adjustments to the Hospital’s regulated revenue for unanticipated events beyond the control of the Hospital that generate substantial increases in the Hospital’s utilization levels, levels but only to the extent that the impact of such events on the Hospital materially and demonstrably exceeds the impact of similar events on other hospitals covered by the GBR model. In summary, the GBR model is a new approach to hospital rate regulation in Maryland. The HSCRC and MedStar, on behalf of the Hospital Hospitals, agree to work together to address any significant unforeseen consequences of this Agreement to ensure that it meets the revenue constraints, savings targets targets, and performance improvement requirements required by the final contract between CMMI and the State of Maryland.

Appears in 2 contracts

Samples: Global Budget Revenue Agreement, Global Budget Revenue Agreement

Other Adjustments. a. The HSCRC and the Hospital Hospitals recognize that some services may be offered more effectively in an unregulated setting. When services covered by the GBR model are moved to an unregulated setting, the HSCRC staff will calculate and apply a reduction to the Hospital's Approved Regulated Revenue. At a minimum, the reduction will ensure that the shift provides a savings to the public and Medicare after taking into consideration the payment amounts likely to be made for the same services in an unregulated setting. b. The HSCRC may initiate a review, or the Hospital System, on behalf of any Hospital may request, request an adjustment to the Hospital's Approved Regulated Revenue to reflect changes in the market share of the that Hospital. The HSCRC staff and the relevant Work Group(s) will be engaged during CY 2014 (and thereafter) in efforts to develop and refine rate setting policies to appropriately adjust for the impact of market share changes. These policies will be designed to separate the impact of reductions in avoidable volumes and volume increases, to the extent possible, from market share changes. c. The HSCRC staff will work with the a Hospital and with other hospitals that adopt the GBR model to calculate and evaluate any volume increases experienced by the Hospital and 2 Health Care Coverage Fund, MHIP, Deficit Assessment, HSCRC and MHCC user fees, NSP, and CRISP are examples of such assessments currently in place and are subject to change by the Commission. 3 For SFY 2014 through 2018, the Hospital will be subject to a Readmission Policy Adjustment. other hospitals that are induced by the expansion of health care coverage under the Affordable Care Act (“ACA”) in 2014 and 2015, for insured populations under the age of 65, net of reductions in volumes for uninsured populations. Based on the 3 For SFY 2014 through 2018, the Hospital will be subject to a Readmission Policy Adjustment. findings of this evaluation, the HSCRC staff may provide a one-time adjustment to the Hospital's Approved Regulated Revenue.4 d. The HSCRC staff will consider one-time adjustments to the Hospital’s regulated revenue for unanticipated events beyond the control of the Hospital that generate substantial increases in the Hospital’s utilization levels, levels but only to the extent that the impact of such events on the Hospital materially and demonstrably exceeds the impact of similar events on other hospitals covered by the GBR model. In summary, the GBR model is a new approach to hospital rate regulation in Maryland. The HSCRC and Hospital System, on behalf of the Hospital Hospitals, agree to work together to address any significant unforeseen consequences of this Agreement to ensure that it meets the revenue constraints, savings targets targets, and performance improvement requirements required by the final contract between CMMI and the State of Maryland.

Appears in 2 contracts

Samples: Global Budget Revenue Agreement, Agreement Between the Health Services Cost Review Commission and Dimensions Healthcare System Regarding Global Budget Revenue and Non Global Budget Revenue

Other Adjustments. a. The HSCRC and the Hospital recognize that some services may be offered more effectively in an unregulated setting. When services covered by the GBR model are moved to an unregulated setting, the HSCRC staff will calculate and apply a reduction to the Hospital's Approved Regulated Revenue. At a minimum, the reduction will ensure that the shift provides a savings to the public and Medicare after taking into consideration the payment amounts likely to be made for the same services in an unregulated setting. b. The HSCRC may initiate a review, or the Hospital System, on behalf of any Hospital may request, request an adjustment to the Hospital's Approved Regulated Revenue to reflect changes in the market share of the that Hospital. The HSCRC staff and the relevant Work Group(s) will be engaged during CY 2014 (and thereafter) in efforts to develop and refine rate setting policies to appropriately adjust for the impact of market share changes. These policies will be designed to separate the impact of reductions in avoidable volumes and volume increases, to the extent possible, from market share changes. c. The HSCRC staff will work with the Hospital and with other hospitals that adopt 2 Health Care Coverage Fund, MHIP, Deficit Assessment, HSCRC and MHCC user fees, NSP, and CRISP are examples of such assessments currently in place and are subject to change by the Commission. 3 For SFY 2014 through 2018, the Hospital will be subject to a Readmission Policy Adjustment. the GBR model to calculate and evaluate any volume increases experienced by the Hospital and other hospitals that are induced by the expansion of health care coverage under the Affordable Care Act (“ACA”) in 2014 and 2015, for insured populations under the age of 65, net of reductions in volumes for uninsured populations. Based on the 3 For SFY 2014 through 2018, the Hospital will be subject to a Readmission Policy Adjustment. findings of this evaluation, the HSCRC staff may provide a one-time adjustment to the Hospital's Approved Regulated Revenue.4 d. The HSCRC staff will consider one-time adjustments to the Hospital’s regulated revenue for unanticipated events beyond the control of the Hospital that generate substantial increases in the Hospital’s utilization levels, levels but only to the extent that the impact of such events on the Hospital materially and demonstrably exceeds the impact of similar events on other hospitals covered by the GBR model. In summary, the GBR model is a new approach to hospital rate regulation in Maryland. The HSCRC and Hospital System, on behalf of the Hospital Hospitals agree to work together to address any significant unforeseen consequences of this Agreement to ensure that it meets the revenue constraints, savings targets and performance improvement requirements required by the final contract between CMMI and the State of Maryland.

Appears in 1 contract

Samples: Global Budget Revenue Agreement

Other Adjustments. a. The HSCRC and the Hospital recognize that some services may be offered more effectively in an unregulated setting. When services covered by the GBR model are moved to an unregulated setting, the HSCRC staff will calculate and apply a reduction to the Hospital's Approved Regulated Revenue. At a minimum, the reduction will ensure that the shift provides a savings to the public and Medicare after taking into consideration the payment amounts likely to be made for the same services in an unregulated setting. b. The HSCRC may initiate a review, or the Hospital may request, an adjustment to the Hospital's Approved Regulated Revenue to reflect changes in the market share of the Hospital. The HSCRC staff and the relevant Work Group(s) will be engaged during CY 2014 (and thereafter) in efforts to develop and refine rate setting policies to appropriately adjust for the impact of market share changes. These policies will be designed to separate the impact of reductions in avoidable volumes and volume increases, to the extent possible, from market share changes. c. The HSCRC staff will work with the Hospital and with other hospitals that adopt the GBR model to calculate and evaluate any volume increases experienced by the Hospital and other hospitals that are induced by the expansion of health care coverage under the Affordable Care Act (“ACA”) in 2014 and 2015, for insured populations under the age of 65, net of reductions in volumes for uninsured populations. Based on the findings of this evaluation, the HSCRC staff may provide a one-time adjustment to the 2 Health Care Coverage Fund, MHIP, Deficit Assessment, HSCRC and MHCC user fees, NSP, and CRISP are examples of such assessments currently in place and are subject to change by the Commission. 3 For SFY 2014 through 2018, the Hospital will be subject to a Readmission Policy Adjustment. findings of this evaluation, the HSCRC staff may provide a one-time adjustment to the Hospital's Approved Regulated Revenue.4 d. The HSCRC staff will consider one-time adjustments to the Hospital’s regulated revenue for unanticipated events beyond the control of the Hospital that generate substantial increases in the Hospital’s utilization levels, levels but only to the extent that the impact of such events on the Hospital materially and demonstrably exceeds the impact of similar events on other hospitals covered by the GBR model. In summary, the GBR model is a new approach to hospital rate regulation in Maryland. The HSCRC and the Hospital agree to work together to address any significant unforeseen consequences of this Agreement to ensure that it meets the revenue constraints, savings targets and performance improvement requirements required by the final contract between CMMI and the State of Maryland.

Appears in 1 contract

Samples: Global Budget Revenue Agreement

Other Adjustments. a. The HSCRC and the Hospital System recognize that some services may be offered more effectively in an unregulated setting. When services covered by the GBR model are moved to an unregulated setting, the HSCRC staff will calculate and apply a reduction to the specific Hospital's Approved Regulated Revenue. At a minimum, the reduction will ensure that the shift provides a savings to the public and Medicare after taking into consideration the payment amounts likely to be made for the same services in an unregulated setting. 2 Health Care Coverage Fund, MHIP, Deficit Assessment, HSCRC and MHCC user fees, NSP, and CRISP are examples of such assessments currently in place and are subject to change by the Commission. 3 For SFY 2014 through 2018, the Hospital will be subject to a Readmission Policy Adjustment. b. The HSCRC may initiate a reviewreview of, or the Hospital System on behalf of any Hospital may request, request an adjustment to the to, any Hospital's Approved Regulated GBR Revenue to reflect changes in the market share of the that Hospital. The HSCRC staff and the relevant Work Group(s) will be engaged during CY 2014 (and thereafter) in efforts to develop and refine rate setting policies to appropriately adjust for the impact of market share changes. These policies will be designed to separate the impact of reductions in avoidable volumes and volume increases, to the extent possible, from market share changes. c. The HSCRC staff will work with the Hospital System, on behalf of the Hospitals, and with other hospitals that adopt the GBR model to calculate and evaluate any volume increases experienced by the Hospital and other hospitals that any Hospital, which are induced by the expansion of health care coverage under the Affordable Care Act (“ACA”) in 2014 and 2015, for insured populations under the age of 65, net of reductions in volumes for uninsured populations. Based on the 3 For SFY 2014 through 2018, the Hospital will be subject to a Readmission Policy Adjustment. findings of this evaluation, the HSCRC staff may provide a one-time adjustment to the an individual Hospital's Approved Regulated Revenue.4 d. The HSCRC staff will consider one-time adjustments to the any Hospital’s regulated revenue for unanticipated events beyond the control of the Hospital that generate substantial increases in the Hospital’s utilization levels, but only to the extent that the impact of such events on the Hospital materially and demonstrably exceeds the impact of similar events on other hospitals covered by the GBR model. In summary, the GBR model is a new approach to hospital rate regulation in Maryland. The HSCRC and the Hospital System, on behalf of the Hospitals, agree to work together to address any significant unforeseen consequences of this Agreement to ensure that it meets achieves the revenue constraints, savings targets targets, and performance improvement requirements required by contained in the final contract between CMMI and the State of Maryland.

Appears in 1 contract

Samples: Global Budget Revenue Agreement

Other Adjustments. a. The HSCRC and the Hospital System recognize that some services may be offered more effectively in an unregulated setting. When services covered by the GBR model are moved to an unregulated setting, the HSCRC staff will calculate and apply a reduction to the Hospital's Approved Regulated Revenue. At a minimum, the reduction will ensure that the shift provides a savings to the public and Medicare after taking into consideration the payment amounts likely to be made for the same services in an unregulated setting. 2 Health Care Coverage Fund, MHIP, Deficit Assessment, HSCRC and MHCC user fees, NSP, and CRISP are examples of such assessments currently in place and are subject to change by the Commission. 3 For SFY 2014 through 2018, the Hospital will be subject to a Readmission Policy Adjustment. b. The HSCRC may initiate a reviewreview of, or the Hospital System, on behalf of any Hospital may request, request an adjustment to the any Hospital's Approved Regulated GBR Revenue to reflect changes in the market share of the that Hospital. The HSCRC staff and the relevant Work Group(s) will be engaged during CY 2014 (and thereafter) in efforts to develop and refine rate setting policies to appropriately adjust for the impact of market share changes. These policies will be designed to separate the impact of reductions in avoidable volumes and volume increases, to the extent possible, from market share changes. c. The HSCRC staff will work with the Hospital System and with other hospitals that adopt the GBR model to calculate and evaluate any volume increases experienced by the each Hospital and other hospitals that are induced by the expansion of health care coverage under the Affordable Care Act (“ACA”) in 2014 and 2015, for insured populations under the age of 65, net of reductions in volumes for uninsured populations. Based on the 3 For SFY 2014 through 2018, the Hospital will be subject to a Readmission Policy Adjustment. findings of this evaluation, the HSCRC staff may provide a one-time adjustment to the Hospital's Approved Regulated Revenue.4 d. The HSCRC staff will consider one-time adjustments to the Hospital’s regulated revenue for unanticipated events beyond the control of the Hospital that generate substantial increases in the Hospital’s utilization levels, but only to the extent that the impact of such events on the Hospital materially and demonstrably exceeds the impact of similar events on other hospitals covered by the GBR model. In summary, the GBR model is a new approach to hospital rate regulation in Maryland. The HSCRC and the Hospital System, on behalf of the Hospitals agree to work together to address any significant unforeseen consequences of this Agreement to ensure that it meets the revenue constraints, savings targets and performance improvement requirements required by contained in the final contract between CMMI and the State of Maryland.

Appears in 1 contract

Samples: Global Budget Revenue Agreement