Shared Savings definition

Shared Savings means the monetary amount owed to the ACO by CMS in accordance with the applicable Risk Arrangement and Appendix B due to expenditures for Medicare Part A and B items and services furnished to Next Generation Beneficiaries lower than the Performance Year Benchmark.

Shared Savings means the monetary amount owed to an ACO by a Payer as determined by comparing the ACO’s expenditures for Enrollees against the Benchmark for that Payer and accounting for the ACO’s performance against any quality measures.

Shared Savings is more particularly defined by each ACO Program, but generally means the portion of Performance Year spending that was less than the expected spending.

Examples of Shared Savings in a sentence

• In some cases, recovery of claim payments associated with a retroactive cancellation may not be possible if, as an example, the recovery (a) conflicts with the Host Blue’s state law or healthcare Provider contracts, (b) would result from Shared Savings and/or Provider Incentive arrangements or (c) would jeopardize the Host Blue’s relationship with its participating healthcare Providers, notwithstanding to the contrary any other provision of this Plan.

• CMS may terminate the participation agreement with an ACO when an ACO, the ACO participants, ACO providers/suppliers or other indi- viduals or entities performing func- tions or services related to ACO activi- ties fail to comply with any of the re- quirements of the Shared Savings Pro- gram under this part.

• Refer to the definition of Shared Savings Program in Section 14, Glossary, of the SPD for details about how the Shared Savings Program applies.

• These Value-Based Programs may include, but are not limited to, Accountable Care Organizations, Global Payment/Total Cost of Care arrangements, Patient Centered Medical Homes and Shared Savings arrangements.

• The Overall Quality Score must function as a multiplier, and may not include a gate; as such, any quality points earned must be associated with a share of the Shared Savings Pool.

More Definitions of Shared Savings

Shared Savings means a program in which the sole source of payment for energy conservation measures or ser- vices provided by a company is a predetermined percentage of the energy cost savings of the user resulting from the energy conservation measure or service.

Shared Savings means a payment mechanism in which the Provider and the Blue Cross and/or Blue Shield Plan share cost savings achieved against a target cost budget based upon agreed-upon terms and may include downside risk.

Shared Savings means the monetary amount owed to an ACO by a payer as determined by comparing the ACO’s expenditures for aligned beneficiaries against the ACO Benchmark for that payer.

Shared Savings has the meaning set forth in Section 4.7(d).

Shared Savings means a payment mechanism in which the provider and payer share cost savings achieved against a target cost budget based upon agreed upon terms and may include downside risk.

Shared Savings means the monetary amount owed to the DCE by CMS due to expenditures for Medicare Part A and Part B items and services furnished to DC Beneficiaries during a Performance Year that are lower than the Performance Year Benchmark. The amount of Shared Savings is determined by CMS in accordance with Appendix B and the Risk Sharing Option and DC Capitation Payment Mechanism selected by the DCE.

Shared Savings means the portion of the difference between Actual Expenditures that are less than Expected Expenditures in a Performance Year that ACO is eligible to receive as payment according to the formulas and procedures set forth in the VMSSP Standards.