Shared Savings Program definition
Examples of Shared Savings Program in a sentence
CMS will maintain the data sharing preferences of Beneficiaries who elect to decline data sharing in this Model or who have previously declined data sharing under the Medicare Shared Savings Program, the Pioneer ACO Model, or the Next Generation ACO Model.
State that participation in the Model may preclude the individual or entity from participating in the Medicare Shared Savings Program, another REACH ACO in the Model, the Vermont Medicare ACO Initiative, the Kidney Care Choices Model, any other Medicare initiative that involves shared savings (except as otherwise specified by CMS), the Primary Care First Model, the Maryland Total Cost of Care Model, and the Independence at Home Demonstration.
Inform the executive of the TIN that a Participant Provider’s participation in the ACO may preclude the entire TIN from participating in the Medicare Shared Savings Program and any other Medicare initiative that involves shared savings and identifies participants by an entire TIN.
The provisions of the Shared Savings Program for Blue Shield 65 Plus Members are set forth in Part B of Exhibit D.
Blue Shield shall provide to Group on a quarterly basis a summary of the funding and expenses in the Shared Savings Program.
The provisions of the Shared Savings Program for Members who are enrolled in Benefit Programs other than Blue Shield 65 Plus are set forth in Part A of Exhibit D.
The national Medicare performance percentile will be equal to the national Medicare 75th percentile used for the Medicare Shared Savings Program quality measure benchmarks for PY1.
Failure to comply with these Additional Provider Obligations as well as the requirements of the Medicare Shared Savings Program and other program integrity issues, including those identified by CMS will result in remedial actions carried out by the ACO Board that may include the imposition of a corrective action plan, denial of incentive payments, and termination of the ACO participant agreement.
The Track 1+ ACO may apply for a SNF 3-Day Rule Waiver following the same procedures outlined in 42 CFR 425.612 and related Shared Savings Program guidance.
The Vermont Medicare Total Cost of Care per Beneficiary Growth and All-payer Total Cost of Care per Beneficiary Growth calculations will be adjusted to incorporate any Shared Losses or Shared Savings for any Vermont ACOs participating in a Medicare FFS ACO initiative (e.g., Vermont Medicare ACO Initiative, Next Generation ACO Model, and Medicare Shared Savings Program).