6: Other (describe), 7: None of the above Mortality or Multi, Multi, 50 words. Percent. Percent. 12 complication rates Checkboxes. Checkboxes. N/A OK. N/A OK. where applicable 1: Individual 1: Primary care, From 0 to 100. From 0 to 100. Physician, 2: Specialty 2: Practice Site, 3: Medical Group/IPA/Staff model Group, 4: PCMH, 5: ACO, 6: Other (describe), 7: None of the above Efficiency Multi, Multi, 50 words. Percent. Percent. 13 (resource use not Checkboxes. Checkboxes. N/A OK. N/A OK. unit cost) 1: Individual 1: Primary care, From 0 to 100. From 0 to 100. Physician, 2: Specialty 2: Practice Site, 3: Medical Group/IPA/Staff model Group, 4: PCMH, 5: ACO, 6: Other (describe), 7: None of the above Pharmacy Multi, Multi, 50 words. Percent. Percent. 14 management (e.g. Checkboxes. Checkboxes. N/A OK. N/A OK. generic use rate, 1: Individual 1: Primary care, From 0 to 100. From 0 to 100. Physician, 2: Specialty formulary 2: Practice Site, compliance) 3: Medical Group/IPA/Staff model Group, 4: PCMH, 5: ACO, 6: Other (describe), 7: None of the above Medication Safety Multi, Multi, 50 words. Percent. Percent. 15 Checkboxes. Checkboxes. N/A OK. N/A OK. 1: Individual 1: Primary care, From 0 to 100. From 0 to 100. Physician, 2: Specialty 2: Practice Site, 3: Medical Group/IPA/Staff model Group,
6: Other (describe), 7: None of the above 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. Percent. N/A OK. From 0 to 100. Percent. N/A OK. From 0 to 100. 12 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. Percent. N/A OK. From 0 to 100. Percent. N/A OK. From 0 to 100. 13 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. Percent. N/A OK. From 0 to 100. Percent. N/A OK. From 0 to 100. 14 Medication Safety Multi, Checkboxes. 1: Individual Physician, 2: Practice Site, 3: Medical Group/IPA/Staff model Group, Multi, Checkboxes. 1: Primary care, 2: Specialty 50 words. Percent. N/A OK. From 0 to 100. Percent. N/A OK. From 0 to 100. 15
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