1 Loss and gain reflected on an incremental basis, rounded to the nearest one tenth of a percent. Loss or gain >8.0% still results in risk sharing reconciliation for the loss or gain between 4.1% and 8.0%. 2 All EOHHS Risk Sharing shall be treated as Medicaid expenditures eligible for FMAP. Demonstration Year 1, if the Contract is terminated prior to June 30, 2015 Incremental Corresponding % Contractor % EOHHS & % CMS Risk % EOHHS Risk Loss or Gain Risk Corridor Risk Sharing CMS Risk Sharing Sharing2 (as % of Total Percentage Sharing Adjusted Capitation Rate Revenue)1 Loss >20% >120.0% 100% 0% 0% 0% Loss > 3% 103.1% to 50% 50% (50%) * (50%)* and ≤ 20% 120.0% (Medicare (Medicaid A/B Percent Percent of Rate) of Rate) Loss >1% 101.1% to 10% 90% (90%) * (90%)* and ≤ 3% 103.0% (Medicare (Medicaid A/B Percent Percent of Rate) of Rate) Loss or Gain 99.0% to 100% 0% 0% 0% ≤ 1% 101.0% Gain >1% 97.0% to 10% 90% (90%) * (90%)* and ≤ 3% 98.9% (Medicare (Medicaid A/B Percent Percent of Rate) of Rate) Gain > 3% 80.0% to 50% 50% (50%) * (50%)* and ≤ 20% 96.9% (Medicare (Medicaid A/B Percent Percent of Rate) of Rate) Gain >20% < 80.0% 100% 0% 0% 0%
1 Loss and gain reflected on an incremental basis, rounded to the nearest one tenth of a percent. Loss or gain >8.0% still results in risk sharing reconciliation for the loss or gain between 4.1% and 8.0%. 2 All EOHHS Risk Sharing shall be treated as Medicaid expenditures eligible for FMAP. Demonstration Year 1, if the Contract is terminated prior to June 30, 2015 Incremental Loss or Gain (as % of Total Adjusted Capitation Rate Revenue)1 Corresponding Risk Corridor Percentage % Contractor Risk Sharing % EOHHS & CMS Risk Sharing % CMS Risk Sharing % EOHHS Risk Sharing2 Loss >20% >120.0% 100% 0% 0% 0% Loss > 3% and ≤ 20% 103.1% to 120.0% 50% 50% (50%) * (Medicare A/B Percent of Rate) (50%)* (Medicaid Percent of Rate) Loss >1% and ≤ 3% 101.1% to 103.0% 10% 90% (90%) * (Medicare A/B Percent of Rate) (90%)* (Medicaid Percent of Rate) Loss or Gain ≤ 1% 99.0% to 101.0% 100% 0% 0% 0% Gain >1% and ≤ 3% 97.0% to 98.9% 10% 90% (90%) * (Medicare A/B Percent of Rate) (90%)* (Medicaid Percent of Rate) Gain > 3% and ≤ 20% 80.0% to 96.9% 50% 50% (50%) * (Medicare A/B Percent of Rate) (50%)* (Medicaid Percent of Rate) Gain >20% < 80.0% 100% 0% 0% 0%