Section 4.6.B.1 above. The Contractor is not obligated to make any additional payment for amounts below 92.0%. 3. Risk Sharing Corridor Tables: (for illustrative purposes only) a. Demonstration Year 1 Incremental % % EOHHS & % CMS % EOHHS Loss or Risk Contractor CMS Risk Risk Risk Gain (as % Corridor Risk Sharing Sharing2 Sharing3 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%) * and ≤ 20% 120.0% (Medicare Percent of A/B Rate) Percent of Rate) Loss >1% 101.1% to 10% 90% (90%) * and ≤ 3% 103.0% (Medicare Percent of A/B Rate) Percent of Rate) Loss or 99.0% to 100% 0% 0% 0% Gain ≤ 1% 101.0% Gain >1% 97.0% to 10% 90% (90%) * and ≤ 3% 98.9% (Medicare Percent of A/B Rate) Percent of Rate) Gain >3% 80.0% to 50% 50% (50%) * and ≤ 20% 96.9% (Medicare Percent of A/B Rate) Percent 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 >20.0% still results in risk sharing reconciliation for the loss or gain between 1.1% and 20.0%.
Section 4.6.B.1 above. The Contractor is not obligated to make any additional payment for amounts below 92.0%. 3. Risk Sharing Corridor Tables: (for illustrative purposes only) a. Demonstration Year 1 Incremental Loss or Gain (as % of Total Adjusted Capitation Rate Revenue)1 Risk Corridor Percentage % Contractor Risk Sharing % EOHHS & CMS Risk Sharing % CMS Risk Sharing2 % EOHHS Risk Sharing3 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) Percent of Rate) Loss >1% and ≤ 3% 101.1% to 103.0% 10% 90% (90%) * (Medicare A/B Percent of Rate) 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) Percent of Rate) Gain >3% and ≤ 20% 80.0% to 96.9% 50% 50% (50%) * (Medicare A/B Percent of Rate) Percent 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 >20.0% still results in risk sharing reconciliation for the loss or gain between 1.1% and 20.0%.
1409-one-care-contract-addendum.docx