If the program pay providers prospectively, please describe the trigger 100 words. event. N/A OK. If the program reconciles the bundled payment retrospectively, please 100 words. describe how the program pays providers during the course of care (e.g. N/A OK. FFS, capitation) and the reconciliation process. 9.4.12.2.9 Indicate the physician/outpatient measures in use for this program. Select all that apply (Note: an expansive list has been provided to facilitate accuracy of reporting, Catalyst for Payment Reform-recommend measures are indicated with*). If using a Composite measure, select composite row and not the individual, underlying measures (e.g., optimal diabetes care) PQRS Measure & Other Level of detail for Indicate if Description Indicate how % Measures comparative reporting of Other (if measure is Physicians reporting of covers primary plan selected used receiving physicians who care and/or response award meet the specialty option 6) threshold of physicians reliability for (HMO) reporting. (HMO) Optimal Diabetes Care Multi, Multi, 50 words. Multi, Percent. Composite* 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: HbA1c Poor Multi, Multi, 50 words. Multi, Percent. Control (>9.0%) 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, 4: P4P Payment (performance
If the program pay providers prospectively, please describe the trigger event. 100 words. N/A OK. If the program reconciles the bundled payment retrospectively, please describe how the program pays providers during the course of care (e.g. FFS, capitation) and the reconciliation process. 100 words. N/A OK. 9.4.12.2.9 Indicate the physician/outpatient measures in use for this program. Select all that apply (Note: an expansive list has been provided to facilitate accuracy of reporting, Catalyst for Payment Reform-recommend measures are indicated with*). If using a Composite measure, select composite row and not the individual, underlying measures (e.g., optimal diabetes care) PQRS Measure & Other Measures Level of detail for comparative reporting of physicians who meet the threshold of reliability for reporting. (HMO) Indicate if reporting covers primary care and/or specialty physicians (HMO) Description of Other (if plan selected response option 6) Indicate how measure is used % Physicians receiving award Optimal Diabetes Care Composite* 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: HbA1c Poor Control (>9.0%) Multi, Checkboxes. 1: Individual Physician, 2: Practice Site, 3: Medical Group/IPA/Staff model Group, 4: PCMH, 5: ACO, 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 Percent.
Qualified%20Health%20Plan%20Certification%20Application%20Fourth%20Quarter%202017%20Smal....docx