Prospective Risk Adjustment definition

Prospective Risk Adjustment. A methodology to account for anticipated variation in risk levels among contracted MCOs, PIHPs, or PAHPs that is derived from historical experience of the contracted MCOs, PIHPs, or PAHPs and applied to rates for the rating period for which the certification is submitted.
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Examples of Prospective Risk Adjustment in a sentence

  • Concept and History of the CMS-HCC Prospective Risk Adjustment Model 5 ii.

  • Acuity Adjustment 34 I.6.B. Appropriate Documentation 34 I.6.B.i. Prospective Risk Adjustment 34 I.6.B.i.(a) Data and Data Adjustments 34 I.6.B.i.(b) Model and Model Adjustments 34 I.6.B.i.(c) Risk Factor Methodology 35 I.6.B.i.(d) Magnitude of Adjustment by MCO 35 I.6.B.i.(e) Predictive Value Assessment 35 I.6.B.i.(f) Actuarial Concerns 35 I.6.B.ii.

  • SDF Various RSA and ABB DME Materials and Equipment Louisville International Airport Rev 0/R2 01600-2 Louisville, KY.

  • Parameters of the CMS-HCC Prospective Risk Adjustment Model 9 ii.

  • The Prospective Risk Adjustment System.” Journal of Ambulatory Care Management, 1999, 22(2), 41-52.

  • Concept and History of the CMS-HCC Prospective Risk Adjustment Model 7 ii.

  • CMS-HCC Prospective Risk Adjustment Model Used in MA Version 24, HCC Definition and Clinical Hierarchies In Medicare, the CMS-HCC prospective risk adjustment model is generally applied to payments where organizations are serving relatively large panels of enrollees or alignedbeneficiaries.

Related to Prospective Risk Adjustment

  • XXXXX Adjustment means, with respect to XXXXX, 0.0326% per annum.

  • Lot line adjustment means the relocation of the property boundary line in a

  • Price Adjustment means any and all price reductions, offsets, discounts, rebates, adjustments, and or refunds which accrue to or are factored into the final net cost to the hospital outpatient department or ambulatory surgical center.

  • SOFR Adjustment means 0.10% (10 basis points).

  • CPI Adjustment means the quotient of (i) the CPI for the month of January in the calendar year for which the CPI Adjustment is being determined, divided by (ii) the CPI for January of 2007.

  • Spread Adjustment means 100 basis points.

  • True-Up Adjustment means any Annual True-Up Adjustment or Interim True-Up Adjustment, as the case may be.

  • Purchase Price Adjustment has the meaning set forth in Section 2.6.

  • Related Adjustment means, in determining any LIBOR Successor Rate, the first relevant available alternative set forth in the order below that can be determined by the Administrative Agent applicable to such LIBOR Successor Rate:

  • Credit Adjustment shall have the meaning specified in Section 3.02.

  • ISDA Fallback Adjustment means the spread adjustment (which may be a positive or negative value or zero) that would apply for derivatives transactions referencing the ISDA Definitions to be determined upon the occurrence of an index cessation event with respect to the Benchmark for the applicable tenor.

  • CMSA NOI Adjustment Worksheet A report substantially in the form of, and containing the information called for in, the downloadable form of the "NOI Adjustment Worksheet" available as of the Closing Date on the CMSA Website, or such other form for the presentation of such information and containing such additional information as may from time to time be recommended by the CMSA for commercial mortgage securities transactions generally and is acceptable to the Master Servicer or the Special Servicer, as applicable, and in any event, shall present the computations made in accordance with the methodology described in such form to "normalize" the full year net operating income and debt service coverage numbers used in the other reports required by this Agreement.

  • Informal adjustment means an agreement reached among the parties, with consultation, but not the consent, of the victim of the crime or other persons specified in KRS 610.070 if the victim chooses not to or is unable to participate, after a petition has been filed, which is approved by the court, that the best interest of the child would be served without formal adjudication and disposition;

  • SNB Adjustment Spread means, with respect to the SNB Policy Rate, the spread to be applied to the SNB Policy Rate in order to reduce or eliminate, to the extent reasonably practicable under the circumstances, any economic prejudice or benefit (as applicable) to Noteholders as a result of the replacement of the Swiss Average Rate Overnight with the SNB Policy Rate for purposes of determining SARON, which spread will be determined by the Calculation Agent, acting in good faith and a commercially reasonable manner, taking into account the historical median between the Swiss Average Rate Overnight and the SNB Policy Rate during the two year period ending on the date on which the SARON Index Cessation Event occurred (or, if more than one SARON Index Cessation Event has occurred, the date on which the first of such events occurred).

  • SOFR Adjustment Conforming Changes means, with respect to any SOFR Rate, any technical, administrative or operational changes (including changes to the interest period, timing and frequency of determining rates and making payments of interest, rounding of amounts or tenors, and other administrative matters) that the Administrator decides, from time to time, may be appropriate to adjust such SOFR Rate in a manner substantially consistent with or conforming to market practice (or, if the Administrator decides that adoption of any portion of such market practice is not administratively feasible or if the Administrator determines that no market practice exists, in such other manner as the Administrator determines is reasonably necessary).

  • Market Value Adjustment means, on a given date, an amount equal to the lesser of (x) 98% and (y) a percentage determined according to the following formula: Market Value Adjustment = 98% – [(10yrCMTt – 10yrCMTlaunch) ×Duration], where 10yrCMTt = the 10-Year Treasury Constant Maturity Rate published each business day by the Board of Governors of the Federal Reserve System, or, if such rate ceases to be published, a successor rate reasonably determined by the Trustees (the “10-Year CMT”), on such repurchase date; 10yrCMTlaunch = the 10-Year CMT as of the end of the Initial Offering Period; and Duration = an estimate of the duration of the periodic interest payments of a hypothetical coupon-paying U.S. Government Security with a 25-year maturity, calculated by the Trust’s Investment Manager as of the end of the Initial Offering Period;

  • Tax Adjustment has the meaning set forth in Section 4.7.

  • MFN Adjustment has the meaning specified in Section 2.14(b).

  • Contract Term Adjustment means adjustment only as provided for in the three circumstances described in this Subsection. Under these circumstances, the contract term shall be adjusted in writing to include additional calendar days in one or more Normal Operating Seasons equal to the actual time lost, except as limited by paragraph (b) in this Subsection.

  • Term SOFR Adjustment means a percentage equal to 0.10% per annum.

  • Open Market Adjustment Amount shall have the meaning specified in Section 2(I).

  • Adjustment Fraction shall have the meaning set forth in Section 11(a)(i) hereof.

  • Day-ahead Congestion Price means the Congestion Price resulting from the Day-ahead Energy Market.

  • Material Project EBITDA Adjustments means, with respect to each Material Project:

  • Adjustment Price means the lowest Underlying Price within the Adjustment Period after the Underlying Price is for the first time equal to or below the Adjustment Threshold.

  • Inflation adjustment means that term as defined in the master settlement agreement.