9.4.7.3 Does the Health plan currently have benefit designs in place that reduce barriers or provide incentives for preventive or wellness services by any of the means listed in the "Financial incentives" column? In the “Uptake” column, estimate the percentage of California members participating in Health plan designs with the barrier reduction or incentive features for the row topic (e.g. diabetes). Numerator should be the number of California members actually enrolled in such a Health plan design/Denominator is total Health plan enrollment. This question does NOT have a regional flag- for uptake percentage, please provide the statewide percentage using numbers in numerator and denominator that reflect the plan's entire membership across all markets. For a regional Health plan operating in only the market of response, their response would be considered statewide in this context. Please respond accordingly in the last column. PPO response - Financial Incentives Uptake as % of total Percentage is based on Preventive and California statewide Health plan's California Wellness Services membership noted membership in all in Section 3 markets of Health plan operation Incentives contingent upon member behavior Participation in Multi, Checkboxes. Percent. Yes/No. 1: Waive/adjust out-of-pocket payments N/A OK. for tests, treatments, Rx contingent upon Medical From 0 to 100. completion/participation, Home Practices 2: Part of program with reduced Premium Share contingent upon completion/participation, 3: Rewards (cash payments, discounts for consumer goods, etc.) administered independently of medical services and contingent upon completion/participation, 4: Waived or decreased for reaching prevention goals, 5: Incentives to adhere to evidence-based self-management guidelines, 6: Incentives to adhere to recommended care coordination encounters, 7: Not supported Participation in other Multi, Checkboxes. Percent. Yes/No. Plan-designated high 1: Waive/adjust out-of-pocket payments N/A OK. for tests, treatments, Rx contingent upon performance practices From 0 to 100. completion/participation, 2: Part of program with reduced Premium Share contingent upon completion/participation, 3: Rewards (cash payments, discounts for consumer goods, etc.) administered
9.4.7.3 Does the Health plan currently have benefit designs in place that reduce barriers or provide incentives for preventive or wellness services by any of the means listed in the "Financial incentives" column? In the “Uptake” column, estimate the percentage of California members participating in Health plan designs with the barrier reduction or incentive features for the row topic (e.g. diabetes). Numerator should be the number of California members actually enrolled in such a Health plan design/Denominator is total Health plan enrollment. This question does NOT have a regional flag- for uptake percentage, please provide the statewide percentage using numbers in numerator and denominator that reflect the plan's entire membership across all markets. For a regional Health plan operating in only the market of response, their response would be considered statewide in this context. Please respond accordingly in the last column. PPO response - Preventive and Wellness Services Financial Incentives Uptake as % of total California statewide membership noted in Section 3 Percentage is based on Health plan's California membership in all markets of Health plan operation Incentives contingent upon member behavior Participation in Medical Home Practices Multi, Checkboxes. 1: Waive/adjust out-of-pocket payments for tests, treatments, Rx contingent upon completion/participation, 2: Part of program with reduced Premium Share contingent upon completion/participation, 3: Rewards (cash payments, discounts for consumer goods, etc.) administered independently of medical services and contingent upon completion/participation, 4: Waived or decreased for reaching prevention goals, 5: Incentives to adhere to evidence-based self-management guidelines, 6: Incentives to adhere to recommended care coordination encounters, 7: Not supported Percent. N/A OK. From 0 to 100. Yes/No. Participation in other Plan-designated high performance practices Multi, Checkboxes. 1: Waive/adjust out-of-pocket payments for tests, treatments, Rx contingent upon completion/participation, 2: Part of program with reduced Premium Share contingent upon completion/participation, 3: Rewards (cash payments, discounts for consumer goods, etc.) administered Percent. N/A OK. From 0 to 100. Yes/No.
Qualified%20Health%20Plan%20Certification%20Application%20Fourth%20Quarter%202017%20Smal....docx