2: Financial incentives (lower incentives or disincentives to premium, waived/lower co-pays) for support the payment reform members to use COE/higher program. performance providers, 3: Financial disincentives for members to use non-COE or lower performing providers (e.g., higher etc.), 4: Use of tiered networks, 5: Use of narrow networks, 6: Reference pricing, 7: High deductible health plans, 8: Value-based insurance design, 9: Incentives to select lower cost sites of care (e.g. worksite clinic, retail clinic, telehealth, ambulatory surgery centers), 10: Preauthorization (e.g. "gatekeeper"), 11: Precertification (e.g. health plan approval), 12: Continued stay review, 13: Step therapy, 14: Objective information (e.g., performance measure results) provided on COEs to members, providing evidence of higher-quality care rendered by these providers, 15: Other (please describe) For this payment reform program, Multi, Checkboxes. 50 words. 21 do you make information 1: We report to the general public, 2: We report to our network transparent such as performance providers (e.g. hospitals and reports on quality, cost and/or physicians), efficiency measures at the 3: We report to patients of our provider level? network providers, 4: We do not report performance on quality measures, 5: We report to state or community data collection processes such as claims databases (APCDs), or AF4Q sites, 6: Other (please describe) Describe evaluation and results Multi, Checkboxes. 100 words. 22 for program 1: Program not evaluated yet, 2: Program evaluation by external third party, 3: Program evaluation by insurer, 4: Evaluation method used pre/post, 5: Evaluation method used matched control group, 6: Evaluation method used randomized control trial, 7: Other evaluation methodology was used (provide details in column to the right)
incentives or disincentives to support the payment reform program. 2: Financial incentives (lower premium, waived/lower co-pays) for members to use COE/higher performance providers, 3: Financial disincentives for members to use non-COE or lower performing providers (e.g., higher etc.), 4: Use of tiered networks, 5: Use of narrow networks, 6: Reference pricing, 7: High deductible health plans, 8: Value-based insurance design, 9: Incentives to select lower cost sites of care (e.g. worksite clinic, retail clinic, telehealth, ambulatory surgery centers), 10: Preauthorization (e.g. "gatekeeper"), 11: Precertification (e.g. health plan approval), 12: Continued stay review, 13: Step therapy, 14: Objective information (e.g., performance measure results) provided on COEs to members, providing evidence of higher-quality care rendered by these providers, 15: Other (please describe) For this payment reform program, do you make information transparent such as performance reports on quality, cost and/or efficiency measures at the provider level? Multi, Checkboxes. 1: We report to the general public, 2: We report to our network providers (e.g. hospitals and physicians), 3: We report to patients of our network providers, 4: We do not report performance on quality measures, 5: We report to state or community data collection processes such as claims databases (APCDs), or AF4Q sites, 6: Other (please describe) 50 words. 21 Describe evaluation and results for program Multi, Checkboxes. 1: Program not evaluated yet, 2: Program evaluation by external third party, 3: Program evaluation by insurer, 4: Evaluation method used pre/post, 5: Evaluation method used matched control group, 6: Evaluation method used randomized control trial, 7: Other evaluation methodology was used (provide details in column to the right) 100 words. 22
Qualified%20Health%20Plan%20Certification%20Application%20Fourth%20Quarter%202017%20Smal....docx