8.4.9.20 Indicate the types of data analyses and reporting available to purchasers and/or their designated vendors on health management and chronic conditions, and the sources of data used to generate the types of analyses and reports available to Covered California. Health plans are expected to help assess and improve health status of their Enrollees using a variety of sources. Check all that apply and which can be documented in the attachment At Risk 3 below. Report Report Report Sources Features for Features for Features for of Data HMO PPO EPO Chronic Multi, Multi, Condition Checkboxes. Checkboxes. Checkboxes. Prevalence 1: 1: 1: results results results 1: reported, reported, reported, HRAs, 2: Comparison 2: Comparison 2: Comparison 2: Medical of of of Claims Data, 3: Comparison 3: Comparison 3: Comparison 3: benchmarks of benchmarks of benchmarks of similarly sized similarly sized similarly sized groups, groups, groups, Claims 4: Trend 4: Trend 4: Trend Data, comparison of comparison of comparison of 4: Lab two years data two years data two years data Values, rolling time rolling time rolling time 5: Other – – – period, period, period, source - 5: Trend 5: Trend 5: Trend please comparison of comparison of comparison of detail two years data two years data two years data below fixed fixed fixed – – – annual annual annual reporting, reporting, reporting, 6: All of the 6: All of the 6: All of the above reports above reports above reports integrated into integrated into integrated into single report, single report, single report, 7: Report 7: Report 7: Report available for available for available for additional fee, additional fee, additional fee, 8: 8: 8: Data/reporting Data/reporting Data/reporting not available not available not available Enrollee (As above) (As above) (As above) (As Population above) stratified by
8.4.9.20 Indicate the types of data analyses and reporting available to purchasers and/or their designated vendors on health management and chronic conditions, and the sources of data used to generate the types of analyses and reports available to Covered California. Health plans are expected to help assess and improve health status of their Enrollees using a variety of sources. Check all that apply and which can be documented in the attachment At Risk 3 below. Report Features for HMO Report Features for PPO Report Features for EPO Sources of Data Chronic Condition Prevalence Multi, Checkboxes. 1: results reported, 2: Comparison of 3: Comparison benchmarks of similarly sized groups, 4: Trend comparison of two years data – rolling time period, 5: Trend comparison of two years data – fixed annual reporting, 6: All of the above reports integrated into single report, 7: Report available for additional fee, 8: Data/reporting not available Multi, Checkboxes. 1: results reported, 2: Comparison of 3: Comparison benchmarks of similarly sized groups, 4: Trend comparison of two years data – rolling time period, 5: Trend comparison of two years data – fixed annual reporting, 6: All of the above reports integrated into single report, 7: Report available for additional fee, 8: Data/reporting not available Checkboxes. 1: results reported, 2: Comparison of 3: Comparison benchmarks of similarly sized groups, 4: Trend comparison of two years data – rolling time period, 5: Trend comparison of two years data – fixed annual reporting, 6: All of the above reports integrated into single report, 7: Report available for additional fee, 8: Data/reporting not available 1: HRAs, 2: Medical Claims Data, 3: Claims Data, 4: Lab Values, 5: Other source - please detail below Enrollee Population stratified by (As above) (As above) (As above) (As above)
2017-QHP-Certification-Application-DRAFT-1-21-16.docx