Executive Summary

Contract performance at a glance · scoring year 2026
0.786
of 1.000
Overall Performance Score (OPS)i
Target 0.868−0.082
OPS = (Final QCR × 65%) + (Contract Oversight × 35%)
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Final QCR Score
0.749/ 1.000
Target 0.850−0.101
Weight in OPS 65%
Contract Oversight
0.855/ 1.000
Target 0.900−0.045
Weight 35% · Client Assumption
Improvement Increment
+0.067/ 0.100
Target +0.100−0.033
Qualifying Measures 2 of 3
QCR Score Summary
ComponentActualTargetDelta
Raw QCR Score (0–5)3.413.75−0.34
Standardized QCR (Raw ÷ 5)0.6820.750−0.068
Improvement Increment+0.067+0.100−0.033
Final QCR Score0.7490.850−0.101
Raw QCR is the weighted average of Initial OPM Scores (0–5) for active QCR measures.
Projected vs Target by Performance Area
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Clinical Quality0.792 / 0.850
Customer Service0.741 / 0.850
Resource Use0.714 / 0.800
Contract Oversight · separate from QCR0.855 / 0.900
Projected (QCR)Contract OversightTarget
QCR Percentile Distribution
Active measures · 2026
7
8
5
4
< 50th 50th – 74th 75th – 89th ≥ 90th
Total Active QCR Measures (2026): 24  ·  NA 2  ·  NR 1  ·  BR 0
Financial Impact — Service Charge (Estimated)i
ScenarioOPSCharge %Est. Chargevs Projected
Projected0.7860.786%$16,711,820—
Target0.8680.868%$18,036,887+$1,325,067
Downside0.7400.740%$15,742,642−$969,178
Projected Incurred Claims
$1,950,000,000
Allowable Admin Expenses
$170,000,000
Total Base (Experience-Rated)
$2,120,000,000
Projected assumes current performance holds · Target is the OPS goal · Downside is the risk case if performance slips below projection.
OPS = (Final QCR × 65%) + (Contract Oversight × 35%)  ·  Improvement Increment capped at +0.100  ·  NA excluded; NR/BR scored as 0. May 31, 2026 10:30 AM ET