5: ACO, or Shared Risk, 6: Other (describe), 4: P4P Payment 7: None of the above (performance determines amount of bonus) Mortality or Multi, Multi, 50 words. Multi, Percent. complication rates Checkboxes. Checkboxes. Checkboxes. where applicable 1: Individual 1: Primary care, 1: Physician Physician, 2: Specialty Feedback, 2: Practice Site, 2: Physician 3: Medical Feedback with Group/IPA/Staff Benchmarking, model Group, 3: Threshold 4: PCMH, Element for P4P 5: ACO, or Shared Risk, 6: Other (describe), 4: P4P Payment 7: None of the above (performance determines amount of bonus) Efficiency (resource Multi, Multi, 50 words. Multi, Percent. use not unit cost) Checkboxes. Checkboxes. Checkboxes. 1: Individual 1: Primary care, 1: Physician Physician, 2: Specialty Feedback, 2: Practice Site, 2: Physician 3: Medical Feedback with Group/IPA/Staff Benchmarking, model Group, 3: Threshold 4: PCMH, Element for P4P 5: ACO, or Shared Risk, 6: Other (describe), 4: P4P Payment 7: None of the above (performance determines amount of bonus) Pharmacy Multi, Multi, 50 words. Multi, Percent. management (e.g. Checkboxes. Checkboxes. Checkboxes. 1: Individual 1: Primary care, 1: Physician generic use rate, Physician, 2: Specialty Feedback, formulary compliance) 2: Practice Site, 2: Physician 3: Medical Feedback with Group/IPA/Staff Benchmarking, model Group, 3: Threshold 4: PCMH, Element for P4P 5: ACO, or Shared Risk, 6: Other (describe), 4: P4P Payment 7: None of the above (performance determines amount of bonus) Medication Safety Multi, Multi, 50 words. Multi, Percent. Checkboxes. Checkboxes. Checkboxes. 1: Individual 1: Physician
5: ACO, 6: Other (describe), 7: None of the above or Shared Risk, 4: P4P Payment (performance determines amount of bonus) Mortality or complication rates where applicable Multi, Checkboxes. 1: Individual Physician, 2: Practice Site, 3: Medical Group/IPA/Staff model Group, 4: PCMH, 5: ACO, 6: Other (describe), 7: None of the above Multi, Checkboxes. 1: Primary care, 2: Specialty 50 words. Multi, Checkboxes. 1: Physician Feedback, 2: Physician Feedback with Benchmarking, 3: Threshold Element for P4P or Shared Risk, 4: P4P Payment (performance determines amount of bonus) Percent. Efficiency (resource use not unit cost) Multi, Checkboxes. 1: Individual Physician, 2: Practice Site, 3: Medical Group/IPA/Staff model Group, 4: PCMH, 5: ACO, 6: Other (describe), 7: None of the above Multi, Checkboxes. 1: Primary care, 2: Specialty 50 words. Multi, Checkboxes. 1: Physician Feedback, 2: Physician Feedback with Benchmarking, 3: Threshold Element for P4P or Shared Risk, 4: P4P Payment (performance determines amount of bonus) Percent. Pharmacy management (e.g. generic use rate, formulary compliance) Multi, Checkboxes. 1: Individual Physician, 2: Practice Site, 3: Medical Group/IPA/Staff model Group, 4: PCMH, 5: ACO, 6: Other (describe), 7: None of the above Multi, Checkboxes. 1: Primary care, 2: Specialty 50 words. Multi, Checkboxes. 1: Physician Feedback, 2: Physician Feedback with Benchmarking, 3: Threshold Element for P4P or Shared Risk, 4: P4P Payment (performance determines amount of bonus) Percent. Medication Safety Multi, Checkboxes. 1: Individual Multi, Checkboxes. 50 words. Multi, Checkboxes. 1: Physician Percent.
Qualified%20Health%20Plan%20Certification%20Application%20Fourth%20Quarter%202017%20Smal....docx