; and (B) the value based outcome adjustment factor shall apply only with respect to the applicable prospective period, and the Secretary shall not take into account such adjustment factor in making payments to hospitals under this section in a subsequent applicable prospective period. (2) Value based outcome adjustment factor (A) In general For purposes of paragraph (1), the value based outcome adjustment factor described in this paragraph for an applicable hospital for an applicable prospective period, subject to subparagraph (B), is equal to 1.0 minus the value based outcome performance fraction determined under paragraph (3) for the hospital and period. (B) Hospital-specific cap and floor In no circumstance may the value based outcome adjustment factor for an applicable hospital for an applicable prospective period under subparagraph (A) be— (i) for applicable prospective periods occurring in fiscal years 2019 through 2022, less than 0.97 or more than 1.03; and (ii) for applicable prospective periods occurring in or after fiscal year 2023, less than 0.95 or more than 1.05. (3) Determination of value based outcome performance fraction (A) In general The value based outcome performance fraction for an applicable hospital for an applicable prospective period, subject to subparagraph (C), is equal to the ratio of— (i) the total hospital-specific financial impact, as defined in subparagraph (B), for the hospital and data collection period with respect to such applicable prospective period