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.
Sample 1

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.

  • In order to support this new methodology, the Model also offers an enhanced voluntary alignment methodology relative to existing Medicare initiatives, Prospective Plus Alignment, which allows ACOs to incorporate new beneficiaries into their aligned beneficiary population on a quarterly basis.

  • In order to support this new methodology, Direct Contracting also offers an enhanced voluntary alignment methodology relative to existing Medicare initiatives, Prospective Plus Alignment, which allows DCEs to incorporate new beneficiaries into their aligned beneficiary population on a quarterly basis.

  • 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.

  • When a DCE elects Prospective Plus Alignment, electronic voluntary alignment will be used quarterly.Q53.

  • Both policies rely on establishing the DCE’s aligned population prospectively to provide a stable prospectively set benchmark for DCEs. However, for those DCEs that select Prospective Plus Alignment, beneficiaries who voluntarily align to the DCE during the performance year will be added to the DCE’s aligned beneficiary population on a quarterly basis prior to the end of the performance year to support more “real time” alignment for those beneficiaries who choose to voluntarily align.

  • For Prospective Plus Alignment, CMS will set a deadline prior to each quarter for PVA submission, which we expect to be about 1 month prior to the start of the quarter.

Related to Prospective Plus Alignment

  • Prospective donor means an individual who is dead or near death and has been determined by a procurement organization to have a part that could be medically suitable for transplantation, therapy, research, or education. The term does not include an individual who has made a refusal.

  • Prospective budgeting means the determination of eligibility and the amount of assistance for a calendar month based on the best estimate of income and circumstances which will exist in that calendar month.

  • prospective sale means a sale which is intended to be made in the future, upon the occurrence of a stated event, whether or not the occurrence of the event is certain;

  • Non-Participating Prosthetic Provider means a Prosthetic Provider who does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Participating Prosthetic Provider means a Prosthetic Provider who has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Non-Participating Home Infusion Therapy Provider means a Home Infusion Therapy Provider who does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Cannabis processing facility means a person that:

  • Prospective Client means any person or entity to which the Corporation, or any of its Subsidiaries, provided, or from which the Corporation, or any of its Subsidiaries received, a proposal, bid, or written inquiry (general advertising or promotional materials and mass mailings excepted) and with which the Participant had contact, or about which the Participant had access to Confidential Information, during the last twelve (12) months of his or her employment.

  • Prospective party means a person that discusses with a prospective collaborative lawyer the possibility of signing a collaborative law participation agreement.

  • Backsiphonage means the flow of water or other liquids, mixtures or substances into the potable water system from any source other than its intended source, caused by the reduction of pressure in the potable water system.

  • Prospective Purchaser has the meaning set forth in Section 2.3(b)(i) hereof.

  • Participating Home Infusion Therapy Provider means a Home Infusion Therapy Provider who has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Prospective employee means any individual who has committed to become an employee of the Company within sixty (60) days from the date an Award is granted to such individual.

  • Similarly situated entity means a first-tier subcontractor, including an independent contractor, that has the same small business program status as that which qualified the prime contractor for the award and that is considered small for the NAICS code the prime contractor assigned to the subcontract the subcontractor will perform. An example of a similarly situated entity is a first-tier subcontractor that is a HUBZone small business concern for a HUBZone set-aside or sole source award under the HUBZone Program.

  • Outdoor cultivation means the cultivation of mature cannabis without the use of artificial lighting or light deprivation in the canopy area at any point in time. Artificial lighting is permissible only to maintain immature plants outside the canopy area.

  • Overburdened community means a geographic area where

  • Member of the household means any person who resides with the public official.

  • Disproportionately impacted area means a census tract or

  • Cardiopulmonary resuscitation or "CPR" means artificial ventilation or external chest compression applied to a person who is unresponsive and not breathing.

  • Self-service storage facility or "facility" means any real property designed or used for the purpose of renting or leasing individual storage space to tenants who are to have access to that space for the purpose of storing and removing personal property.

  • Prospective contractor means a person who is subject to the competitive sealed proposal process set forth in the Procurement Code or is not required to submit a competitive sealed proposal because that person qualifies for a sole source or a small purchase contract.

  • Qualified incubator facility means a commercial building

  • Stinger-steered automobile or watercraft transporter means an automobile or watercraft transporter

  • Medical marijuana concentrate means a specific subset of Medical Marijuana that was produced by extracting cannabinoids from Medical Marijuana. Categories of Medical Marijuana Concentrate include Water-Based Medical Marijuana Concentrate, Food-Based Medical Marijuana Concentrate and Solvent-Based Medical Marijuana Concentrate.

  • Family or household members means spouses, domestic partners, former spouses, former domestic partners, persons who have a child in common regardless of whether they have been married or have lived together at any time, adult persons related by blood or marriage, adult persons who are presently residing together or who have resided together in the past, persons sixteen years of age or older who are presently residing together or who have resided together in the past and who have or have had a dating relationship, persons sixteen years of age or older with whom a person sixteen years of age or older has or has had a dating relationship, and persons who have a biological or legal parent-child relationship, including stepparents and stepchildren and grandparents and grandchildren.

  • Prospective tenant means a tenant or a person who has