18: Orange, 19: San Diego Summary/Brief N/A 500 words. description of Program (500 words or less) Identify the line(s) Multi, Checkboxes. 50 words. of business for 1: Self-insured which this program commercial, is available? 2: Fully-insured commercial, 3: Medicare, 4: Medicaid, 5: Other please – describe in next column What is current Single, group. To the day. stage of 1: Planning mode, implementation. 2: Pilot mode (e.g. only Provide date of available for a subset of implementation in members and/or detail column providers), 3: Expansion mode (e.g. passed initial pilot stage and broadening reach), 4: Full implementation (e.g. available to all intended/applicable providers and members) To which payment Single, Radio group. 65 reform model does 1: Shared-risk (other your program most than bundled payment) closely align? and/or gainsharing with For programs that quality, have hybrid 2: FFS-based qualities, review the with quality, list of definitions to 3: Non-FFS-based decide which Shared-savings with payment model quality, best describes your 4: FFS plus pay for program, or is the performance, most dominant 5: Full capitation with payment reform quality, model of those that 6: Partial or are used in the capitation with program. quality, 7: Bundled payment with quality,
18: Orange, 19: San Diego Summary/Brief description of Program (500 words or less) 500 words. N/A Identify the line(s) of business for which this program is available? Multi, Checkboxes. 1: Self-insured commercial, 2: Fully-insured commercial, 3: Medicare, 4: Medicaid, 5: Other – please describe in next column 50 words. What is current stage of implementation. Provide date of implementation in detail column Single, group. 1: Planning mode, 2: Pilot mode (e.g. only available for a subset of members and/or providers), 3: Expansion mode (e.g. passed initial pilot stage and broadening reach), 4: Full implementation (e.g. available to all intended/applicable providers and members) To the day. To which payment reform model does your program most closely align? For programs that have hybrid qualities, review the list of definitions to decide which payment model best describes your program, or is the most dominant payment reform model of those that are used in the program. Single, Radio group. 1: Shared-risk (other than bundled payment) and/or gainsharing with quality, 2: FFS-based with quality, 3: Non-FFS-based Shared-savings with quality, 4: FFS plus pay for performance, 5: Full capitation with quality, 6: Partial or capitation with quality, 7: Bundled payment with quality, 65
2017-QHP-Certification-Application-DRAFT-1-21-16.docx