Vermont Medicare ACO Initiative Benchmarks definition

Vermont Medicare ACO Initiative Benchmarks means the ACO Benchmarks applicable to VMA ACOs and Vermont Modified Next Generation ACOs.
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Examples of Vermont Medicare ACO Initiative Benchmarks in a sentence

  • CMS will assess the Vermont Medicare ACO Initiative Benchmarks to ensure consistency with standards set forth in section 8.b.ii.1 and will make a decision on whether to approve the Vermont Medicare ACO Initiative Benchmarks submitted by the GMCB, as discussed in section 8.b.ii.

  • CMS shall collaborate with the GMCB to analyze and understand data to inform how Vermont Medicare ACO Initiative Benchmarks are set for Vermont Modified Next Generation ACOs and VMA ACOs.

  • CMS may exercise its authority to modify or set the Vermont Medicare ACO Initiative Benchmarks as articulated in sections 7.c and 9.d.

  • Except as described in sections 7.c and 9.d, the GMCB shall prospectively develop the Vermont Medicare ACO Initiative Benchmarks for both Vermont Modified Next Generation ACOs and VMA ACOs for Performance Year 1 and subsequent Performance Years in accordance with the terms of this Agreement and subject to CMS approval.

  • If the Annual Projected National Medicare Total Cost of Care per Beneficiary Growth for Performance Year 1 is calculated to be greater than or equal to 3.7 percent, the growth rates for Vermont Medicare ACO Initiative Benchmarks for Performance Year 1 must be at least 0.1 percentage points below the Annual Projected National Medicare Total Cost of Care per Beneficiary Growth for Performance Year 1.

  • The Vermont Medicare ACO Initiative Benchmarks should incentivize high-quality care, promote efficient care, and support improvement in the health of aligned beneficiaries.

  • CMS shall work with the GMCB throughout the year prior to each Performance Year to analyze and understand data to inform how Vermont Medicare ACO Initiative Benchmarks are set for Vermont Modified Next Generation ACOs and VMA ACOs.

  • CMS may exercise its authority to set the Vermont Medicare ACO Initiative Benchmarks as articulated in Sections 5.c and 6.d of this Agreement.

  • If for Performance Year 1 the Projected National Medicare Total Cost of Care per Beneficiary Growth is calculated to be greater than or equal to 3.7 percent, have the growth rates for Vermont Medicare ACO Initiative Benchmarks come in at least 0.1 percentage points below the Projected National Medicare Total Cost of Care per Beneficiary Growth for Performance Year 1.

  • For Performance Year 1 of the Model, before the Initiative begins, Vermont shall develop the Vermont Medicare ACO Initiative Benchmarks for each Vermont Modified Next Generation ACO in the same manner as the requirements, exceptions, and standards articulated in Sections 5.c, 6.d, and 7.b.ii of this Agreement.

Related to Vermont Medicare ACO Initiative Benchmarks

  • Pharmacy benefits management means the administration or management of prescription drug

  • Managed care plan means a health benefit plan that either requires a covered person to use, or

  • Managed Care Plans means all health maintenance organizations, preferred provider organizations, individual practice associations, competitive medical plans and similar arrangements.

  • Title IV-E Foster Care means a federal program authorized under §§ 472 and 473 of the Social

  • Adult foster care means room and board, supervision, and special services to an adult who has a

  • Statewide popular election means a general election in which votes are cast for

  • Pharmacy benefits manager means a person that performs pharmacy benefits management.

  • Number of Students Who Began Program means the number of students who began the program who are scheduled to complete the program within the reporting calendar year.

  • Foster care services means the provision of a full range of casework, treatment and community

  • Health care plan means any contract, policy or other arrangement for benefits or services for medical or dental care or treatment under:

  • Participating Hospice Care Program Provider means a Hospice Care Program Provider that either: (i) has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield to provide services to participants in this benefits program, or; (ii) a Hospice Care Program Provider which has been designated by a Blue Cross and/or Blue Shield Plan as a Participating Provider Option program.

  • Non-Participating Hospice Care Program Provider means a Hospice Care Program Provider that either: (i) does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield to provide services to participants in this benefits program, or; (ii) a Hospice Care Program Provider which has not been designated by a Blue Cross and/or Blue Shield Plan as a Participating Provider Option program.

  • Medical flexible spending arrangement or "medical FSA" means a benefit plan whereby eligible state employees may reduce their salary before taxes to pay for medical expenses not reimbursed by insurance as provided in the salary reduction plan established under chapter

  • Qualified medical provider means the same as that term is defined in Section 26-61a-102.

  • Medicare Advantage plan means a plan of coverage for health benefits under Medicare Part C as defined in 42 U.S.C. 1395w-28(b)(1), and includes:

  • Objective medical evidence means reports of examinations or treatments; medical signs which are anatomical, physiological, or psychological abnormalities that can be observed; psychiatric signs which are medically demonstrable phenomena indicating specific abnormalities of behavior, affect, thought, memory, orientation, or contact with reality; or laboratory findings which are anatomical, physiological, or psychological phenomena that can be shown by medically acceptable laboratory diagnostic techniques, including but not limited to chemical tests, electrocardiograms, electroencephalograms, X-rays, and psychological tests;

  • Seller 401(k) Plan shall have the meaning set forth in Section 6.01(i).

  • Adult foster care facility means an adult foster care facility licensed under the adult foster care facility licensing act, 1979 PA 218, MCL 400.701 to 400.737.

  • Long-term inpatient care means inpatient services for

  • National Medical Support Notice or “NMSN” shall mean a notice that contains the following information:

  • Child Care Program means a person or business that offers child care.

  • Palliative care means medical service rendered to reduce or moderate temporarily the intensity of an otherwise stable medical condition, but does not include those medical services ren- dered to diagnose, heal or permanently alleviate or eliminate a medical condition.

  • Asset Management Plan means a strategic document that states how a group of assets are to be managed over a period of time. The plan describes the characteristics and condition of infrastructure assets, the levels of service expected from them, planned actions to ensure the assets are providing the expected level of service, and financing strategies to implement the planned actions. The plan may use any appropriate format, as long as it includes the information and analysis required to be in a plan as described in Ontario’s Building Together: Guide for Asset Management Plans.

  • Number of Students Who Began the Program means the number of students who began a program who were scheduled to complete the program within 100% of the published program length within the reporting calendar year and excludes all students who cancelled during the cancellation period.

  • Centers for Medicare and Medicaid Services or “CMS” means the federal office under the Secretary of the United States Department of Health and Human Services, responsible for the Medicare and Medicaid programs.

  • Pharmacy care means medications prescribed by a licensed physician and any health-related services considered medically necessary to determine the need or effectiveness of the medications.