Performance Year Benchmark definition

Performance Year Benchmark means the target expenditure amount to which Medicare Part A and Part B expenditures for items and services furnished to REACH Beneficiaries during a Performance Year are compared in order to calculate Shared Losses or Shared Savings, as determined by CMS in accordance with Appendix B of the Agreement.
View Source
Performance Year Benchmark means the target expenditure amount to which actual Medicare Part A and Part B expenditures for Next Generation Beneficiaries during a
View Source

Examples of Performance Year Benchmark in a sentence

  • Except for calculations made as part of a settlement reopening conducted pursuant to Section 12.04.D, CMS may not recalculate the Performance Year Benchmark under Section 11.02.B after the issuance of the settlement report as described in Section 12.04 for the relevant Performance Year.

  • If CMS retroactively modifies or replaces the trend factor used in calculating the Performance Year Benchmark pursuant to Section 11.02.A, CMS will recalculate the Performance Year Benchmark using the new trend factor according to the methodology described in Appendix B of the Agreement.

  • In order to accommodate recalculation of the Performance Year Benchmark pursuant to Section 11.02.B, CMS may at its sole discretion delay settlement under Section 12.04 of the Agreement for the affected Performance Year for up to 60 Days.

  • If the ACO accepts such offer, the ACO will be subject to the alignment minimum described in Section 5.03.A and the Performance Year Benchmark methodology for Standard ACOs described in Section I of Appendix B for each subsequent Performance Year.

  • For each Performance Year, CMS shall determine the ACO’s Performance Year Benchmark according to the methodology in Appendix B.

  • CMS will use Prospective Plus Alignment to calculate quarterly updates to the ACO’s Performance Year Benchmark and to determine the amount of the PCC Payment, TCC Payment, or APO payment the ACO will receive from CMS for each month of the applicable calendar quarter.

  • CMS will notify the ACO of any recalculation of the Performance Year Benchmark made pursuant to Section 11.02.B.

  • For the relevant Performance Year, CMS will provide preliminary, interim, provisional (if the ACO selected Provisional Financial Settlement), and final data to the ACO detailing the ACO’s Performance Year Benchmark throughout the Performance Year, as detailed in Sections 11.01.B, 11.01.C, and 12.04.A.2, if applicable, and 12.04.A.3, respectively.

  • The Quarterly Benchmark Report may include adjustments to the Performance Year Benchmark resulting from updated information regarding any factors that affect the Performance Year Benchmark calculation described in Appendix B.

  • The Risk Arrangement selected by the ACO in accordance with Section X.A of the Agreement will determine the portion of the aggregate gross savings or losses in relation to the Performance Year Benchmark that accrue to the ACO as Shared Savings or Shared Losses.