Risk Arrangement definition

Risk Arrangement means the arrangement selected by the ACO that determines the portion of the savings or losses in relation to the Performance Year Benchmark that accrue to the ACO as Shared Savings or Shared Losses.
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Risk Arrangement is defined to include both “risk-sharing arrangement” and “risk-shifting arrangement,” which are defined as follows: (a) Risk-Sharing Arrangement means any compensation arrangement between Provider and Health Plan under which Provider shares the risk of financial gain or loss with Health Plan. (b) Risk-Shifting Arrangement means a contractual arrangement between Provider and Health Plan under which Health Plan pays Provider on a fixed, periodic or capitated basis, and the financial risk for the cost of services provided pursuant to the contractual arrangement is assumed by Provider.
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Examples of Risk Arrangement in a sentence

  • 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.

  • In instances in which aggregate gross ACO savings/losses exceed the Savings/Losses Cap selected by the ACO, the Savings/Losses Cap is first applied to determine the maximum allowable savings/losses, and the Risk Arrangement is then applied to that maximum allowable savings/loss amount.

  • The Savings/Losses Cap is the maximum allowable percentage of the ACO’s Performance Year Benchmark that will be paid to the ACO as Shared Savings or owed by the ACO as Shared Losses, subject to the application of the Risk Arrangement selected by the ACO.

  • General‌ For each Performance Year, CMS shall pay the ACO in accordance with (i) the Alternative Payment Mechanism, if any, for which CMS has approved the ACO under Section X.C; (ii) the Risk Arrangement for which the ACO has been approved or deemed approved by CMS under Section X.B; (iii) Appendix B; (iv) Section XIII; and (v) this Section XIV.

  • For example, if the ACO selects a 5% Savings/Losses Cap and a 80% Risk Arrangement, the ACO would share in savings/losses up to 4% [80% of the 5% maximum allowable savings/losses] of its Performance Year Benchmark.

  • For example, if the budget sequestration rate is 2%, the amount of Shared Savings owed to the ACO would be 98% of any savings calculated after application of the Savings/Losses Cap and the Risk Arrangement as described above, but the amount of Shared Losses owed by the ACO would be 100% of any losses calculated after application of the Savings/Losses Cap and the Risk Arrangement as described above.

  • Risk Arrangement A: 80% Shared Savings/Shared Losses, ACO selects a Savings/Losses Cap between 5%-15%.

  • Risk Arrangement B: 100% Shared Savings/Shared Losses, ACO selects a Savings/Losses Cap between 5%-15%.

  • It is the intent of the Depositor and Certificateholders that, for federal income taxes, state and local income or franchise taxes and other taxes imposed on or measured by income, the Certificates will be treated as evidencing beneficial ownership interests in a REMIC and, if applicable, a Basis Risk Arrangement.

  • Risk Arrangement, Savings/Losses Cap, and Expenditure Cap Approval‌ The ACO’s Risk Arrangement, Savings/Losses Cap selection, and expenditure cap selection, if applicable, for the first Performance Year, and for each subsequent Performance Year, shall be deemed approved unless rejected in writing by CMS within 30 days after submission.