6: Other (describe), determines 7: None of the above amount of bonus) CDC: Eye Exam Multi, Multi, 50 words. Multi, Percent. 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) CDC: Hemoglobin A1c Multi, Multi, 50 words. Multi, Percent. (HbA1c) testing 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) CDC: Foot Exam Multi, Multi, 50 words. Multi, Percent. 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) CDC: Medical Attention Multi, Multi, 50 words. Multi, Percent. for Nephropathy Checkboxes. Checkboxes. Checkboxes. 1: Individual 1: Primary care, 1: Physician Physician, 2: Specialty Feedback, 2: Practice Site, 2: Physician 3: Medical Feedback with
6: Other (describe), 7: None of the above determines amount of bonus) CDC: Eye Exam 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. CDC: Hemoglobin A1c (HbA1c) testing 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. CDC: Foot Exam 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. CDC: Medical Attention for Nephropathy Multi, Checkboxes. 1: Individual Physician, 2: Practice Site, 3: Medical Multi, Checkboxes. 1: Primary care, 2: Specialty 50 words. Multi, Checkboxes. 1: Physician Feedback, 2: Physician Feedback with Percent.
Qualified%20Health%20Plan%20Certification%20Application%20Fourth%20Quarter%202017%20Smal....docx