Total For comparison. Percent. Percent. Multi, For 17 dollars $0.00 comparison. paid to Unknown payment 1: ACO, Note: 2: PCMH, reform Percentages 3: Medical programs provided in Groups/IPAs on this row do FFS. 4: Primary not total one Care, AUTOSUM hundred 5: ROWS 8, percent Specialists 10 and 14 Total For comparison. Percent. Percent. Multi, For 18 dollars $0.00 comparison. paid to Unknown 1: ACO, payment Note: 2: PCMH, reform Percentages 3: Medical programs provided in Groups/IPAs NOT this row do on FFS. 4: Primary not total one Care, AUTOSUM hundred 5: ROWS 7, 9, percent Specialists 11-13, 15 and 16 9.4.12.14.4 Based on your responses above, on an aggregate basis for the plan’s total commercial book of business in the market of your response, indicate the relative weighting or allocation of the Plan's financial incentives for hospital services, and which payment approaches, if any, the Contractor is using currently to tie payment to performance If the relative weighting varies by contract, describe the most prevalent allocation. The Plan's response should total 100.00% within each column. Enter 0.00% if incentives not use. Hospital Services Estimate of Product Type of Payment Description Row Allocation of where Approach of other Number Incentive incentive payments available (see question above) Achievement (relative to Percent. Single, Multi, Checkboxes. 65 words. 1 1: Shared-risk (other target or peers) of Clinical Pull-down than bundled payment) process goals (e.g., list. and/or gainsharing with 1: HMO, prophylactic antibiotic quality, 2: PPO, administration, timeliness of 2: FFS-based 3: Both HMO medication administration, with quality, and PPO, 3: Non-FFS-based testing, screenings) 4: Not Shared-savings with available quality, 4: FFS plus pay for performance,
Groups/IPAs Groups/IPAs Total dollars paid to payment reform programs on FFS. AUTOSUM ROWS 8, 10 and 14 For comparison. $0.00 Percent. Percent. Multi, 1: ACO, 2: PCMH, 3: Medical 4: Primary Care, 5: Specialists For comparison. Unknown Note: Percentages provided in this row do not total one hundred percent 17 Total dollars paid to payment reform programs NOT on FFS. AUTOSUM ROWS 7, 9, 11-13, 15 and 16 For comparison. $0.00 Percent. Percent. Multi, 1: ACO, 2: PCMH, 3: Medical 4: Primary Care, 5: Specialists For comparison. Unknown Note: Percentages provided in this row do not total one hundred percent 18 9.4.12.14.4 Based on your responses above, on an aggregate basis for the plan’s total commercial book of business in the market of your response, indicate the relative weighting or allocation of the Plan's financial incentives for hospital services, and which payment approaches, if any, the Contractor is using currently to tie payment to performance If the relative weighting varies by contract, describe the most prevalent allocation. The Plan's response should total 100.00% within each column. Enter 0.00% if incentives not use. Hospital Services Estimate of Allocation of Incentive payments (see question above) Product where incentive available Type of Payment Approach Description of other Row Number Achievement (relative to target or peers) of Clinical process goals (e.g., prophylactic antibiotic administration, timeliness of medication administration, testing, screenings) Percent. Single, Pull-down list. 1: HMO, 2: PPO, 3: Both HMO and PPO, 4: Not available Multi, Checkboxes. 1: Shared-risk (other than bundled payment) and/or gainsharing with quality, 2: FFS-based with quality, 3: Non-FFS-based Shared-savings with quality, 4: FFS plus pay for performance, 65 words. 1