HCRP definition
Examples of HCRP in a sentence
For each RC with an HCRP, a portion of the base MassHealth Component will be withheld from all s into a risk pool.
The HCRP Premium is communicated to the CONTRACTOR and included in the Capitation Rate signature sheets.
The risk corridors will be reconciled after application of any HCRP or risk adjustment methodologies (e.g. CMS-HCC), and as if all Contractors had received the full quality withhold payment.
HCRP reconciliation will occur annually based on nine (9) months of claims run-out after the end of each calendar year Applicable costs: Cost must be for Covered Services incurred while Enrollee is in the Rating Category applicable to the pool.
Members and their costs must meet certain criteria to be considered in the HCRP Premium and Reconciliation, outlined in Attachment 6: Reconciliations and Risk Corridor Evaluation Methodologies.
The risk pool fund is determined based on each CONTRACTOR’s contribution based on actual membership for the rating period and the corresponding HCRP premium.
The risk corridors will be reconciled after application of any HCRP or risk adjustment methodologies (e.g. CMS‑HCC), and as if all Contractors had received the full quality withhold payment.
To achieve this purpose, the RHC may assist in monitoring the implementation of the County’s five-year HCRP by setting priorities and making funding decisions on projects and programs that implement the HCRP.
HCRP reconciliation will occur annually based on nine (9) months of claims run‑out after the end of each calendar year Applicable costs: Cost must be for Covered Services incurred while Enrollee is in the Rating Category applicable to the pool.
HCA reserves the right to modify the HCRP criteria for future contract years.