Whether or not the Contractor has met the quality withhold requirements in a given year will be made public. Additional details regarding the quality withholds, including the more detailed specifications, required thresholds and other information regarding the methodology will be made available in future technical guidance. 5. Withhold Measures in Demonstration Year 1 Figure 4.1 below identifies core withhold measures for Demonstration Year 1. Together, these will be utilized as the basis for a 1% withhold. Additional details, including technical specifications, withhold methodology and required benchmarks, will be provided in subsequent guidance. Because Demonstration Year 1 crosses calendar and Contract years, the Contractor will be evaluated to determine whether it has met required quality withhold requirements at the end of both CY 2013 and CY 2014. The determination in CY 2013 will be based solely on those measures that can appropriately be calculated based on the actual enrollment volume during CY 2013. Consistent with such evaluations, the withheld amounts will be repaid separately for each calendar year. Figure 4.1: Quality Withhold Measures for Demonstration Year 1 CMS Core Measure Withhold Steward/Data Measure Withhold Measure Description Source Measure Encounter data (for CY Submission of production Prescription CMS/State X 2014 only) Drug Event and Risk Adjustment defined System files. process measure Assessments Percent of Enrollees with an in-person CMS/State X assessment for care planning purposes defined completed within 90 days of enrollment. process measure
Whether or not the Contractor has met the quality withhold requirements in a given year will be made public. Additional details regarding the quality withholds, including the more detailed specifications, required thresholds and other information regarding the methodology will be made available in future technical guidance. 5. Withhold Measures in Demonstration Year 1 Figure 4.1 below identifies core withhold measures for Demonstration Year 1. Together, these will be utilized as the basis for a 1% withhold. Additional details, including technical specifications, withhold methodology and required benchmarks, will be provided in subsequent guidance. Because Demonstration Year 1 crosses calendar and Contract years, the Contractor will be evaluated to determine whether it has met required quality withhold requirements at the end of both CY 2013 and CY 2014. The determination in CY 2013 will be based solely on those measures that can appropriately be calculated based on the actual enrollment volume during CY 2013. Consistent with such evaluations, the withheld amounts will be repaid separately for each calendar year. Figure 4.1: Quality Withhold Measures for Demonstration Year 1 Measure Description Measure Steward/Data Source CMS Core Withhold Measure Withhold Measure Encounter data (for CY 2014 only) Submission of production Prescription Drug Event and Risk Adjustment System files. CMS/State defined process measure X Assessments Percent of Enrollees with an in-person assessment for care planning purposes completed within 90 days of enrollment. CMS/State defined process measure X