Alignment Minimum Clause Samples
Alignment Minimum. A. If the ACO is a Standard ACO, the ACO shall maintain an aligned population of at least 5,000 REACH Beneficiaries each Performance Year. If the ACO is a Standard ACO, the ACO shall maintain at least 3,000 Beneficiaries that would have been aligned to the ACO via Claims-Based Alignment for Base Year One, Base Year Two, or Base Year Three (as defined in Appendix A) for Performance Year 2023 and each subsequent Performance Year.
B. If the ACO is a New Entrant ACO, the ACO shall maintain an aligned population of REACH Beneficiaries consistent with the following:
1. [Reserved]
2. For Performance Year 2023, at least 2,000 REACH Beneficiaries;
3. For Performance Year 2024, at least 3,000 REACH Beneficiaries;
4. For Performance Year 2025, at least 4,000 REACH Beneficiaries; and at least 3,000 of these REACH Beneficiaries must be aligned to the ACO via Claims-Based Alignment; and
5. For Performance Year 2026, at least 5,000 REACH Beneficiaries; and at least 3,000 of these REACH Beneficiaries must be aligned to the ACO via Claims-Based Alignment. For Performance Years 2023 and 2024, if more than 3,000 Beneficiaries are aligned to the ACO via Claims-Based Alignment for Base Year One, Base Year Two, or Base Year Three (as defined in Appendix A), CMS will offer the ACO the opportunity to participate in the Model as a Standard ACO starting in the Performance Year in which the 3,000 threshold is exceeded. If the ACO accepts such offer, the ACO will be subject to the alignment minimum described in Section 5.03.A and the Performance Year Benchmark methodology for Standard ACOs described in Section I of Appendix B for each subsequent Performance Year.
C. If the ACO is a High Needs Population ACO, the ACO shall maintain an aligned population of REACH Beneficiaries consistent with the following:
1. [Reserved]
2. For Performance Year 2023, at least 500 REACH Beneficiaries;
3. For Performance Year 2024, at least 750 REACH Beneficiaries;
4. For Performance Year 2025, at least 1,000 REACH Beneficiaries; and
5. For Performance Year 2026, at least 1,250 REACH Beneficiaries. For Performance Years 2023 and 2024, if more than 3,000 Beneficiaries are aligned to the ACO via Claims-Based Alignment for Base Year One, Base Year Two, or Base Year Three (as defined in Appendix A) CMS will calculate the Performance Year Benchmark based in part on the Performance Year Benchmark methodology for Beneficiaries aligned via Claims-Based Alignment to Standard ACOs, as described in Section III.D of...
Alignment Minimum.
1. The ACO shall maintain an aligned population of at least 10,000 Next Generation Beneficiaries during each Performance Year, unless the ACO is a Rural ACO.
2. If the ACO is a Rural ACO, the ACO shall maintain an aligned population of at least 7,500 Next Generation Beneficiaries during each Performance Year.
3. If at any time during a Performance Year, the ACO’s aligned population falls below the applicable minimum, CMS shall notify the ACO, request a corrective action plan (CAP) pursuant to Section XIX, and require the ACO to satisfy the applicable minimum aligned population requirement by a date specified by CMS. If the ACO’s aligned population remains below the applicable minimum required under this section by the specified date, CMS may take further remedial action and/or terminate this Agreement pursuant to Section XIX.