Medicare-Medicaid Plan (MMP) Quality Withhold Methodology & Technical Notes

Medicare-Medicaid Plan (MMP) Quality Withhold Methodology & Technical Notes


10/19/2023: CMS released the revised "Capitated Financial Alignment Demonstration Years 2-12 QW Methodology & CMS Core Technical Notes." More information is available below.

MMPs participating in the capitated model will have a portion of their rates withheld; payment of these withheld amounts is subject to performance consistent with established quality requirements. The quality withhold analysis results for each demonstration will be posted to the state-specific pages as they become available.

More information on the Quality Withhold (QW) methodology and benchmarks is available below:

Additionally, information about the QW adjustment for extreme and uncontrollable circumstances (such as major natural disasters) and QW impacts due to the Coronavirus Disease 2019 (COVID-19) public health emergency (PHE) can be found in the memoranda below:






New York - Fully Integrated Duals Advantage (FIDA)

New York - FIDA Intellectual and Development Disabilities (FIDA-IDD)


Rhode Island

South Carolina



(demonstration ended 12/31/2017)
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Page Last Modified:
10/20/2023 11:50 AM