Shared Savings. An employee shall be eligible to receive payment from the District equal to one-half (1/2) of up to $2,000 in savings recovered by the District where the savings result from the identification by the employee of errors in his/her hospital/surgical/medical bills.
Shared Savings. Shared Savings if earned will be distributed according to the Performance Year Shared Risk and Savings Policy as set forth in the Agreement and each Participant’s Maximum Risk and Sharing Limit.
Shared Savings. The NRC reserves the right to include the following shared savings clause in any order.
Shared Savings the amount to be paid by EOHHS to the Contractor under the Contractor’s Risk Track, in the event the Contractor has Savings, as described in Section 4.3. Significant BH Needs – substance use disorder, SED, SPMI and other BH conditions as specified by EOHHS. Startup and Ongoing Support Payments – DSRIP payments that support the Contractor’s development, infrastructure, and investments in new care delivery models, as described in Section 5.2.A. State Agency Liaison – one of the Contractor’s Key Personnel roles, as described in Section 2.4.A. Taxpayer Identification Number –as defined by the Internal Revenue Service (IRS), an identification number issued by the IRS or by the Social Security Administration (SSA). A Social Security number (SSN) is issued by the SSA whereas all other TINs are issued by the IRS. Total Cost of Care (TCOC) – a measure of the costs of care for a population of Members during a defined period, as described in Section 4.3.D.1. TCOC Benchmark – a target measure of the Contractor’s TCOC for the Contract Year, as described in Section 4.3.D.2.
Shared Savings. Shared Savings if earned will be contributed to a Value Based Incentive Pool which shall be distributed to Participants and/or Affiliates in a manner consistent with ACO strategy and approved by the Board of Managers. The Board of Managers may alter or amend the policies for Shared Savings during this Agreement.
Shared Savings. Provider acknowledges and agrees that Shared Savings, if any, received from CMS will be based on the performance of the DCE as a whole and not on individual providers. In the event Shared Savings are achieved or shared losses incurred, such Shared Savings or Shared Losses will be distributed pursuant to an objective methodology adopted by the DCE’s Governing Body EXHIBIT E COMPENSATION Compensation for Primary Care Services from DCE XXX has elected to participate in the Primary Care Capitation Payment Mechanism under the Direct Contracting Model. In connection with DCE’s participation therein, and in accordance with the form of Direct Contracting Model: Fee Reduction Agreement attached hereto as Exhibit F, Provider shall, and shall require its Practice Providers to, accept as payment in full for its provision of health care services and laboratory services customarily furnished by or through a Primary Care Specialist and specifically those CPT/HCPC codes specified by CMS in advance of January 1, 2022 (“Primary Care Services”), payments from DCE in accordance with the rates set forth in Table 1 below. For purposes of this section, a Primary Care Specialist is defined to mean a physician or non- physician practitioner (“NPP”) who has a primary specialty in primary care, such as general practice (CMS Specialty Code: 1), family medicine (CMS Specialty Code: 8), internal medicine (CMS Specialty Code: 11), pediatric medicine (CMS Specialty Code: 37), geriatric medicine (CMS Specialty Code: 38), nurse practitioner (CMS Specialty Code: 50), clinical nurse specialist (CMS Specialty Code: 89), or physician assistant (CMS Specialty Code: 97). CMS will specify a list of CMS specialty codes for Primary Care Specialists prior to the start of the relevant Performance Year. Therefore, this list may be subject to change. TABLE 1 CPT/HCPC Code Description Rate (Percentage of CMS Medicare physician fee schedule) 96160-96161 Administration of HRA 110% 99201-99205 Outpatient Visit New 110% 99211-99215 Outpatient Visit Established 110% 99339-99340 Home Care Plan Oversight Services 110% 99354-99355 Prolonged Care 110% 99495-99496 Transitional Care Mgmt. 110% 99324-99328,99334-99337,99339-99345,99347-99350 Home Care E&M 110% 99421-99423,99441-99443 Telephone Visits (Audio Only) 110% 99497-99498 Advanced Care Planning 110% G0402, G0438, G0439 Welcome to Medicare & AWV 110% 99487, 99489,99490, G0506 Chronic Care Mgmt. 110% G2010-G2012 Virtual Check-ins 110% 99484, 99492,99493, 9949...
Shared Savings. During the 1998/1999 negotiations, the SEIU bargaining unit agreed to a contract change in the delivery of health benefits to CalPERS. This change produced an estimated savings equal to approximately a 1% increase in salaries of SEIU bargaining unit members. During the life of this contract (2002-2005) the District shall continue to share any savings resulting from this action to the SEIU bargaining unit.
Shared Savings the amount to be paid by EOHHS to the Contractor under the Contractor’s Risk Track, in the event the Contractor has Savings, as described in Section 4.3. Significant BH Needs – substance use disorder, SED, SPMI and other BH conditions as specified by EOHHS. Startup and Ongoing Support Payments – DSRIP payments that support the Contractor’s development, infrastructure, and investments in new care delivery models, as described in Section 5.2.A. State Agency Liaison – one of the Contractor’s Key Personnel roles, as described in Section 2.4.A. Total Cost of Care (TCOC) – a measure of the costs of care for a population of Members during a defined period, as described in Section 4.3.D.1. TCOC Benchmark – a target measure of the Contractor’s TCOC for the Contract Year, as described in Section 4.3.D.2.
Shared Savings. A payment mechanism in which the Provider and the payer share cost savings achieved against a target cost budget based on agreed upon terms and may include downside risk.
Shared Savings. At the sole discretion of the DCE, and as set forth by the Governing Body, Provider may be eligible to receive up to twenty percent (20%) of the per capita Xxxxxx Xxxxxxx achieved by the DCE. Participant eligibility requirements and calculation of Shared Savings payments to Provider will be set forth by the Governing Body. DCE will bare responsibilities for downside losses. At no time is the provider required to pay any sums related to payment made by the DCE to CMS for healthcare expenditures above the Performance Year benchmark, otherwise known as “downside risk” or shared losses.
