Prospective Plus Alignment definition

Prospective Plus Alignment refers to the Alignment Methodology in which Beneficiaries are aligned to the ACO prospectively prior to the start of a Performance Year, based on both Claims- Based Alignment and Voluntary Alignment, and aligned prospectively prior to the start of the second through fourth calendar quarters of a Performance Year, to align additional Beneficiaries based only on Voluntary Alignment.
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Prospective Plus Alignment refers to the Alignment Methodology in which Beneficiaries are aligned to the DCE only prospectively prior to the start of a Performance Year, based on both Claims-Based Alignment and Voluntary Alignment, and aligned prospectively prior to the start of the second through fourth calendar quarters of a Performance Year, to align additional Beneficiaries based only on Voluntary Alignment.
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Examples of Prospective Plus Alignment in a sentence

  • Marketing Events do not involve health screenings or any other activity that is used, or could be perceived as being used, to avoid treating At-Risk Beneficiaries or to target certain Beneficiaries for services for the purpose of trying to affect the population of Beneficiaries aligned to the ACO for a subsequent Performance Year or, if the ACO has selected Prospective Plus Alignment as described in Section 8.01, a subsequent quarter of the current Performance Year.

  • 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.

  • Failure to comply with the requirements of this Article V and, if the ACO has selected to participate in SVA, the requirements of Appendix C of the Agreement, may result in retroactive reversal of any alignment of Beneficiaries to the ACO that occurred solely pursuant to Voluntary Alignment, to include via Prospective Plus Alignment.

  • Marketing Events do not involve health screenings or any other activity that is used, or could be perceived as being used, to avoid treating At-Risk Beneficiaries or to target certain Beneficiaries for services for the purpose of trying to affect the population of Beneficiaries aligned to the DCE for a subsequent Performance Year or, if the DCE has selected Prospective Plus Alignment as described in Section 8.01, a subsequent quarter of the current Performance Year.

  • Retroactively reverse the alignment of Beneficiaries to the ACO that is based solely on Voluntary Alignment, to include Prospective Plus Alignment.

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

  • If the DCE has selected Prospective Plus Alignment for the Performance Year as described in Section 8.01 of the Agreement, CMS will also align Beneficiaries to the DCE at the start of the second through fourth quarters of the Performance Year through Voluntary Alignment.

  • CMS will automatically run Electronic Voluntary Alignment for purposes of Beneficiary alignment, including for Prospective Plus Alignment (if the DCE has selected Prospective Plus Alignment for the Performance Year as described in Section 8.01 of the Agreement).

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