Common use of Scoring Methodology for ACO Quality Score Clause in Contracts

Scoring Methodology for ACO Quality Score. The Contractor’s Quality Score is based on the Contractor’s performance across a set of benchmarks and improvement targets for individual quality measures that are grouped into three domains. An additional bonus element is also included for PY2024 based on an assessment of Electronic Quality Measurements/Electronic Clinical Data System readiness, as specified by EOHHS. EOHHS will weight and sum the Contractor’s performance across all domains and then apply results of the bonus element to calculate one overall ACO Quality Score per performance year. For any measure where the Contractor does not meet minimum denominator requirements, as determined by EOHHS, then the measure’s weight will be equally distributed to other measures within the same domain. For ACOs serving primarily pediatric members (e.g., > 75% of the ACO’s Enrollees are ages 0-17 years), EOHHS shall replace adult focused measures (i.e., measures applicable to 18+ populations only) with measure(s) applicable to pediatric populations only (“pediatric replacement measures”) as further specified by EOHHS. Quality Performance on these pediatric replacement measures will be scored as described above.