Model Requirements. As a condition ofthe Waiver set forth in Section 4.c., over the performance period of this Model, the State must reduce the aggregate Medicare 30-day unadjusted all-cause, all-site hospital readmission rate ("Readmission Rate") for Medicare FFS beneficiaries such that, by the end of Performance Year 5, Regulated Maryland Hospitals have achieved equal to or less than the national Readmission Rate for Medicare FFS beneficiaries at the end of Performance Year 5. If in a given Performance Year Regulated Maryland Hospitals, in aggregate, fail to outperform the national Readmissions Rate change by an amount equal to or greater than the cumulative difference between the Regulated Maryland Hospital and national Readmission Rates in the base period divided by five, CMS shall follow the corrective action and/or termination provisions of the Waiver of Section 1886(q) as set forth in Section 4.c and in Section 14. CMS shall consider whether the State can demonstrate that it is implementing a program for Regulated Maryland Hospitals and, as applicable, other hospitals in Maryland that achieves or surpasses the measured results in terms of patient outcomes and cost savings established under Section 1886(q) of the Act.
Model Requirements. As a condition of the Waiver set forth in Section 4.d, over the performance period of this Agreement, the State must achieve an aggregate 30.0% reduction across all 65 Potentially Preventable Conditions (PPC) that comprise Maryland's Hospital Acquired Condition program. The State shall calculate percentage achievement in accordance with the methodology set forth in Appendix 6. The State will provide CMS with the calculation and, in accordance with applicable law, all underlying data necessary to validate the calculation. Prior to Performance Year 2, CMS and Maryland will establish annual reduction targets for PPCs that overlap with conditions indicated in Appendix 6. If the State fails to achieve an aggregate 6. 89% reduction across all 65 PPCs that comprise Maryland's Hospital Acquired Condition program in a given Performance Year, CMS shall follow the corrective action and/or termination provisions of the Waiver of Section 1886(P) as set forth in Section 14. CMS shall consider whether the State can demonstrate that it is implementing a program for Regulated Maryland Hospitals and, as applicable, other hospitals in Maryland that achieves or surpasses the measured results in terms of patient outcomes and cost savings established under Section 1 886(q) ofthe Act.
Model Requirements
