Alternative Payment Methodology definition

Alternative Payment Methodology or “APM” means a

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Alternative Payment Methodology has the meaning provided for in ORS 414.025.

Alternative Payment Methodology means a payment other than a fee-for-services payment, used by Contractor as compensation for the provision of integrated and coordinated health care and services. “Alternative Payment Methodology” includes, but is not limited to:

Examples of Alternative Payment Methodology in a sentence

If EOHHS has approved an Alternative Payment Methodology (APM) for the Contractor, EOHS shall apply an adjustment to the Contractor’s repriced paid claims comparable to the APM adjustment that EOHHS used with respect to the Contractor during Capitation Rate development for the Contract Year.
EOHHS will consider the withhold, for the prorated period of July 1, 2018 through December 31, 2018, as earned due to the Contractor’s efforts in advancing the development of APMs. The withheld amounts will be repaid as quarterly adjusting payments subject to the Contractor’s demonstration that it has achieved the threshold values in APM payments for the reporting period as set forth in Section ▇.▇▇.▇▇.▇▇.▇▇ (Alternative Payment Methodology for Each Contract Period).
If the Contractor has sub-capitated or Alternative Payment Methodology (APM) arrangements with providers, the sub-capitated or APM payments to providers should be increased by the equivalent of the rate increases that would be required for fee for service payments as set forth in this section.
An Alternative Payment Methodology means a payment methodology structured such that it provides economic incentives, rather than focusing on volume of services provided, focus upon such key areas as: • Improving quality of care; • Improving population health; • Impacting cost of care and/or cost of care growth; • Improving patient experience and engagement; and • Improving access to care.
As part of this support, the Contractor shall work with PCMPs to ensure readiness for the Primary Care Alternative Payment Methodology (APM).
The full encounter rate shall be at least equal to the Prospective Payment System (PPS) rate specific to each FQHC/RHC and applies to FQHC/RHC reimbursed under the Alternative Payment Methodology (APM) rate methodology and to FQHC/RHC reimbursed under the PPS rate methodology.
An Alternative Payment Methodology means a payment methodology structured such that it provides economic incentives, rather than focusing on volume of services provided, focus upon such key areas as:  Improving quality of care;  Improving population health;  Impacting cost of care and/or cost of care growth;  Improving patient experience and engagement; and  Improving access to care.
Beginning on or after December 1, 2016, the PH-MCO must also make a payment separate from the PPS rate(s) to any FQHC that has opted–in to the Alternative Payment Methodology for inpatient deliveries.
Contractor’s submission of Alternative Payment Methodology data to APAC, together with the submission of its Encounter Data, will wholly fulfill Contractor’s responsibility for APAC reporting.

More Definitions of Alternative Payment Methodology

Alternative Payment Methodology or "APM" means a reimbursement that is an alternative to the standard reimbursement established in Section 3 of this administrative regulation in accordance with 42 U.S.C. 1396a(bb)(6).

Alternative Payment Methodology includes, but is not limited to:

Alternative Payment Methodology or “APM” means a payment made from a Medi-Cal managed care plan to a designated public hospital system for services covered for a beneficiary assigned to a designated public hospital system that meets the conditions set forth in the Special Terms and Conditions and approved by the department, as applicable.

Alternative Payment Methodology means a payment methodology structured such that provider economic incentives, rather than focus on volume of services provided, focus upon:

Alternative Payment Methodology means a payment other than a fee-for-services payment, used by coordinated care organizations as compensation for the provision of integrated and coordinated health care and services. ‘Alternative Payment Methodology’ includes, but is not limited to: