0 of 8.4.8.6 If the Health plan differentiates its contracted physicians via tiered networks or other plan design that provide financial incentives to "steer" consumers to a subset of higher performing providers, please complete the following table for total commercial book of business in market of response. If plan has 40 specialties and only 21 of 40 are eligible for tiered networks, plan should provide the number of physicians in the 21 specialties eligible to be tiered rather than number of physicians in the 40 specialties. Primary care Specialty care Tiered networks, PCMH or ACOs not Multi, Multi, used Checkboxes - Checkboxes - optional. optional. 1: Not used 1: Not used Number of physicians in full product Decimal. Decimal. network N/A OK. N/A OK. From 0 to From 0 to 10000000000. Number of physicians in preferred (As above) (As above) tier/narrow network(exclude in PCMHs and ACOs) Percent of network physicians in For comparison. For comparison. preferred tier/narrow network N/A% N/A% Number of physicians in PCMH only Decimal. Decimal. (exclude those in ACOs) N/A OK. N/A OK. From 0 to From 0 to 10000000000. 10000000000.
of 0 8.4.8.6 If the Health plan differentiates its contracted physicians via tiered networks or other plan design that provide financial incentives to "steer" consumers to a subset of higher performing providers, please complete the following table for total commercial book of business in market of response. If plan has 40 specialties and only 21 of 40 are eligible for tiered networks, plan should provide the number of physicians in the 21 specialties eligible to be tiered rather than number of physicians in the 40 specialties. Primary care Specialty care Tiered networks, PCMH or ACOs not used Multi, Checkboxes - optional. 1: Not used Multi, Checkboxes - optional. 1: Not used Number of physicians in full product network Decimal. N/A OK. From 0 to 10000000000. Decimal. N/A OK. From 0 to Number of physicians in preferred tier/narrow network(exclude in PCMHs and ACOs) (As above) (As above) Percent of network physicians in preferred tier/narrow network For comparison. N/A% For comparison. N/A% Number of physicians in PCMH only (exclude those in ACOs) Decimal. N/A OK. From 0 to 10000000000. Decimal. N/A OK. From 0 to 10000000000.
2017-QHP-Certification-Application-DRAFT-1-21-16.docx