functions. this row do 4: Primary (see not total Care, definitions 100% 5: for Specialists examples) in CY 2015 or most recent 12 months. Provide the Dollars. Percent. Percent. Multi, For 15 total N/A OK. N/A OK. N/A OK. comparison. dollars paid From 0 to Unknown 1: ACO, for Note: 2: PCMH, Percentages 3: Medical non-visit provided in Groups/IPAs functions. this row do (see 4: Primary not total Care, definitions 100% 5: for Specialists examples) in CY 2015 or most recent 12 months. Provide the Dollars. Percent. Percent. Multi, For 16 total N/A OK. N/A OK. N/A OK. comparison. dollars paid From 0 to Unknown to 1: ACO, Note: 2: PCMH, providers Percentages 3: Medical whose provided in Groups/IPAs contract this row do contains 4: Primary not total Care, other types 100% 5: of Specialists incentive program not captured above and NOT on FFS
Groups/IPAs Groups/IPAs functions. (see definitions for examples) in CY 2015 or most recent 12 months. 4: Primary Care, 5: Specialists this row do not total 100% Provide the total dollars paid for non-visit functions. (see definitions for examples) in CY 2015 or most recent 12 months. Dollars. N/A OK. From 0 to Percent. N/A OK. Percent. N/A OK. Multi, 1: ACO, 2: PCMH, 3: Medical 4: Primary Care, 5: Specialists For comparison. Unknown Note: Percentages provided in this row do not total 100% 15 Provide the total dollars paid to providers whose contract contains other types of incentive program not captured above and NOT on FFS Dollars. N/A OK. From 0 to Percent. N/A OK. Percent. N/A OK. Multi, 1: ACO, 2: PCMH, 3: Medical 4: Primary Care, 5: Specialists For comparison. Unknown Note: Percentages provided in this row do not total 100% 16
Qualified%20Health%20Plan%20Certification%20Application%20Fourth%20Quarter%202017%20Smal....docx