Prospective Risk Adjustment definition

Prospective Risk Adjustment. A methodology to account for anticipated variation in risk levels among contracted MCOs, PIHPs, or PAHPs that is derived from historical experience of the contracted MCOs, PIHPs, or PAHPs and applied to rates for the rating period for which the certification is submitted.
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Examples of Prospective Risk Adjustment in a sentence

  • Model Segments (Subpopulations) for the CMS-HCC Risk Adjustment Model CMS-HCC Non-ESRD CMS-HCC Prospective Risk Adjustment Example Risk Score.

  • However, the low demand for allowances was primarily a result of the substantial emission reductions achieved by the complementary policies.

  • Conclusion 35Appendix A: CMMI-HCC Coefficients 37Appendix B: Concurrent Risk Adjustment Relative Factors 39Appendix C: Example Application of Normalization, the Symmetric 3% Cap with Demographic Adjustment, and the CIF for Standard and New Entrant ACOs Using the CMS-HCC Prospective Risk Adjustment Model 45Appendix D: Example Application of Normalization and the Symmetric Risk Score Growth Cap to Risk Scores for KCEs Using the CMS-HCC Prospective Risk Adjustment Model 51 I.

  • For more detailed information on the CMS-HCC model see the 2023 Advance Notices and Announcement https://www.cms.gov/files/document/2023-advance-notice.pdf.• a set of number of payment HCC (count) indicator variables to allow higher predicted expenditures for beneficiaries with larger numbers of HCCs. CMS-HCC Prospective Risk Adjustment Model Segments.

  • EvaluATE has changed my understanding of how evaluation can be done.PI EvaluATE has done a wonderful job.

  • Acuity Adjustment 34 I.6.B. Appropriate Documentation 34 I.6.B.i. Prospective Risk Adjustment 34 I.6.B.i.(a) Data and Data Adjustments 34 I.6.B.i.(b) Model and Model Adjustments 34 I.6.B.i.(c) Risk Factor Methodology 35 I.6.B.i.(d) Magnitude of Adjustment by MCO 35 I.6.B.i.(e) Predictive Value Assessment 35 I.6.B.i.(f) Actuarial Concerns 35 I.6.B.ii.

  • In MODE 5, only a single control rod can be withdrawn from a core cell containing fuel assemblies.

  • SDF Various RSA and ABB DME Materials and Equipment Louisville International Airport Rev 0/R2 01600-2 Louisville, KY.

  • Parameters of the CMS-HCC Prospective Risk Adjustment Model 9 ii.

  • A very small fraction of farmers (less than 1%) produces vegetables, fruits, or spices (SAERP, 1997).

Related to Prospective Risk Adjustment

  • Lot line adjustment means the relocation of the property boundary line in a

  • SOFR Adjustment means 0.10% (10 basis points).

  • Purchase Price Adjustment shall have the meaning specified in Section 3.02.

  • Related Adjustment means, in determining any LIBOR Successor Rate, the first relevant available alternative set forth in the order below that can be determined by the Administrative Agent applicable to such LIBOR Successor Rate:

  • ISDA Fallback Adjustment means the spread adjustment (which may be a positive or negative value or zero) that would apply for derivatives transactions referencing the ISDA Definitions to be determined upon the occurrence of an index cessation event with respect to the Benchmark for the applicable tenor.

  • Informal adjustment means an agreement reached among the parties, with consultation, but not the consent, of the victim of the crime or other persons specified in KRS 610.070 if the victim chooses not to or is unable to participate, after a petition has been filed, which is approved by the court, that the best interest of the child would be served without formal adjudication and disposition;

  • SOFR Adjustment Conforming Changes means, with respect to any SOFR Rate, any technical, administrative or operational changes (including changes to the interest period, timing and frequency of determining rates and making payments of interest, rounding of amounts or tenors, and other administrative matters) that the Administrator decides, from time to time, may be appropriate to adjust such SOFR Rate in a manner substantially consistent with or conforming to market practice (or, if the Administrator decides that adoption of any portion of such market practice is not administratively feasible or if the Administrator determines that no market practice exists, in such other manner as the Administrator determines is reasonably necessary).

  • Contract Term Adjustment means adjustment only as provided for in the three circumstances described in this Subsection. Under these circumstances, the contract term shall be adjusted in writing to include additional calendar days in one or more Normal Operating Seasons equal to the actual time lost, except as limited by paragraph (b) in this Subsection. To qualify for such adjustment, Purchaser shall give written notice of the lost time not later than 30 days after end of Normal Operating Season in which time was lost and at least 10 days before Termination Date. Contracting Officer shall make prompt written acknowledgment of such notice, indicating concurrence with the number of days in the notice or the number of days Forest Service considers as qualifying for the adjustment. Lost portions of days shall be disregarded in computing time lost. The three circumstances qualifying for a Contract Term Adjustment are:

  • Term SOFR Adjustment means a percentage equal to 0.10% per annum.

  • Adjustment Fraction shall have the meaning set forth in Section 11(a)(i) hereof.

  • Material Project EBITDA Adjustments means, with respect to each Material Project:

  • Adjustment Right means any right granted with respect to any securities issued in connection with, or with respect to, any issuance or sale (or deemed issuance or sale in accordance with Section 2) of shares of Common Stock (other than rights of the type described in Section 3 and 4 hereof) that could result in a decrease in the net consideration received by the Company in connection with, or with respect to, such securities (including, without limitation, any cash settlement rights, cash adjustment or other similar rights).