Physician, 1: Primary care, Feedback, 2: Practice Site, 2: Specialty 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) Breast Cancer Multi, Multi, 50 words. Multi, Percent. Screening* 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) Colorectal Cancer Multi, Multi, 50 words. Multi, Percent. Screening* 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) Endoscopy/Polyp Multi, Multi, 50 words. Multi, Percent. Surveillance: Checkboxes. Checkboxes. Checkboxes. Colonoscopy Interval 1: Individual 1: Primary care, 1: Physician Physician, 2: Specialty Feedback, for Patients with a 2: Practice Site, 2: Physician History of 3: Medical Feedback with Adenomatous Group/IPA/Staff Benchmarking, Avoidance of model Group, 3: Threshold 4: PCMH, Element for P4P Inappropriate Use* 5: ACO, or Shared Risk, 6: Other (describe), 4: P4P Payment 7: None of the above (performance determines
Physician, 2: Practice Site, 3: Medical Group/IPA/Staff model Group, 4: PCMH, 5: ACO, 6: Other (describe), 7: None of the above 1: Primary care, 2: Specialty Feedback, 2: Physician Feedback with Benchmarking, 3: Threshold Element for P4P or Shared Risk, 4: P4P Payment (performance determines amount of bonus) Breast Cancer Screening* 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. Colorectal Cancer Screening* 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. Endoscopy/Polyp Surveillance: Colonoscopy Interval for Patients with a History of Adenomatous of Inappropriate Use* 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 Percent. Avoidance
Qualified%20Health%20Plan%20Certification%20Application%20Fourth%20Quarter%202017%20Smal....docx