MLR Incentive Adjustment definition

MLR Incentive Adjustment means the performance based incentive to lower the MLR Incentive Threshold based on the performance score. The MLR Incentive Adjustment should not be more than the difference between the MLR Incentive Threshold and the Minimum MLR of 85%.
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Examples of MLR Incentive Adjustment in a sentence

  • The VBP Significance Component of the MLR Incentive Adjustment will be calculated as set out below.

  • If the Contractor has a MLR of less than eighty five percent (85%) then the incentive based Premium Rebate will be limited to the difference between the Maximum MLR Incentive Adjustment and the MLR Incentive Adjustment.

  • VBP Adoption Component The VBP Adoption Component of the MLR Incentive Adjustment shall contribute up to one (1) percentage point.

  • If one (1) threshold is met but not the other then the VBP Adoption Component of the MLR Incentive Adjustment shall be set at one half (.5) of a percentage point.

  • The MLR Incentive Adjustment will consist of four (4) additive components: a Quality Component (up to two (2) percentage points), a WA HBE Component (up to one (1) percentage point), a VBP Adoption Component (up to one (1) percentage point), and a VBP Significance Component (up to one (1) percentage point).

  • The MLR Incentive Adjustment Quality Score will be multiplied by three (3) percentage points to determine the Quality Component of the MLR Incentive Adjustment.

  • If, for the Plan Year, the VBP Significance Score is equal to or exceeds the VBP Significance Threshold Score, then the VBP Significance Component of the MLR Incentive Adjustment shall be set at one (1) percentage point.

  • VBP Significance Component The VBP Significance Component of the MLR Incentive Adjustment shall contribute up to one (1) percentage point to the MLR Incentive Adjustment.

  • The result, capped at a maximum of one hundred percent (1.000), will be the Contractor’s MLR Incentive Adjustment Quality Score.

  • This percentage shall be referred to herein as the “VBP Significance Score.” This “VBP Significance Score” shall be compared to the VBP Significance Threshold Score, which is set at one percent (1%) to determine the VBP Significance Component of the MLR Incentive Adjustment.