in next column) Adoption of CPOE Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: non-visit 9: 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus)
non-visit 10: policy for specific services that were or services that were 11: Other non-FFS based payment reform models (describe in next column) Management of Patients in ICU Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment
Evidence-Based Hospital referral indicators Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: non-visit 9: non-visit 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus)
1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: non-visit 9: non-visit 10: 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus)
policy for specific services that were or services that were 11: Other non-FFS based payment reform models (describe in next column) Maternity –elective c-section rates Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus)
Physician or physician group, 4: Other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: non-visit 9: non-visit 10: policy for specific services that 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus)
were or services that were 11: Other non-FFS based payment reform models (describe in next column) HOSPITAL QUALITY INSTITUTE HOSPITAL ENGAGEMENT NETWORK Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus)
that were 11: Other non-FFS based payment reform models (describe in next column) CLABSI Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus)
11: Other non-FFS based payment reform models (describe in next column) Adverse drug events (ADE) Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus)
with quality, 8: non-visit 9: non-visit 10: policy for specific services that were or services that were 11: Other non-FFS based payment reform models (describe in next column) AGENCY FOR HEALTHCARE RESEARCH AND QUALITY (AHRQ)* Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or
payment reform models (describe in next column) Inpatient quality indicators Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus)
non-visit 9: non-visit 10: policy for specific services that were or services that were 11: Other non-FFS based payment reform models (describe in next column) Patient safety indicators Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment
in next column) Prevention quality indicators Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: non-visit 9: 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus)
non-visit 10: policy for specific services that were or services that were 11: Other non-FFS based payment reform models (describe in next column) OTHER MEASURES Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment
HACs – hospital conditions (e.g., Surgical site infection following coronary artery bypass graft Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: non-visit 9: non-visit 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus)
payment 10: policy for specific services that were or services that were 11: Other non-FFS based payment reform models (describe in next column) SREs (serious reportable events) that are not HACs (e.g., surgery on the wrong body part or wrong patient) www.qualityforum.org/Topics/SREs/List_of_SREs.aspx . Please refer to attachment Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus)
payment 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: non-visit 9: non-visit 10: 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus)
Physician or physician group, 4: Other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: non-visit 9: non-visit 10: policy for specific services that 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus)
were or services that were 11: Other non-FFS based payment reform models (describe in next column) MORTALITY MEASURES (AMI, HF and Pneumonia mortality measures) Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus)
with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: non-visit 9: non-visit 10: policy for specific services that were or services that were Element for P4P or Shared Risk, 4: P4P Payment amount of bonus)
11: Other non-FFS based payment reform models (describe in next column) Osteoarthritis- Hospital-Level Risk-Standardized Complication Rate Following Elective Primary Total Hip Arthroplasty and/or Total Knee Arthroplasty Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus)
quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: non-visit 9: non-visit 10: policy for specific services that were or services that were 11: Other non-FFS based Shared Risk, 4: P4P Payment amount of bonus)
payment reform models (describe in next column) Low Back Pain- Use of Imaging Studies for Low Back Pain Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus)
non-visit 9: non-visit 10: policy for specific services that were or services that were 11: Other non-FFS based payment reform models (describe in next column) Low Back Pain - Functional Status Change for Patients with Lumbar Impairments Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment
with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: non-visit 9: non-visit 10: policy for specific services that were or services that were 11: Other non-FFS based payment reform models (describe amount of bonus)
in next column) Rate of hospital-level observation stays Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: non-visit 9: based 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus) based
Other standard measures by National Quality Forum (describe): Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: non-visit 9: non-visit 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus) based based
Entity Paid Type of of Other how is used % HQA ACUTE MYOCARDIAL INFARCTION (AMI) Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus)
with quality, 7: Bundled payment with quality, 8: non-visit 9: non-visit 10: policy for specific services that were or services that were 11: Other non-FFS based payment reform models (describe in next column) HEART FAILURE (HF) Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with 65 words. Multi, 1: Hospital 2: Hospital with
11: Other non-FFS based payment reform models (describe in next column) PNEUMONIA (PNE) Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus)
with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: non-visit 9: non-visit 10: policy for specific services that were or services that were 11: Other based for P4P or Shared Risk, 4: P4P Payment amount of bonus)
8: non-visit 9: non-visit 10: policy for specific services that were or services that were 11: Other non-FFS payment reform models (describe in next column) PATIENT EXPERIENCE/H-CAHPS Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: based 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, based
models (describe in next column) LEAPFROG Safety Practices Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: non-visit 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus) based based
in next column) Adoption of CPOE Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: non-visit 9: 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus) based based
non-visit 10: policy for specific services that were or services that were 11: Other non-FFS payment reform models (describe in next column) Management of Patients in ICU Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment based
Evidence-Based Hospital referral indicators Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: non-visit 9: non-visit 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus) based based
10: policy for specific services that were or services that were 11: Other non-FFS payment reform models (describe in next column) Adoption of NQF Safe Practices Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus) based
1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: non-visit 9: non-visit 10: 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus) based based
policy for specific services that were or services that were 11: Other non-FFS payment reform models (describe in next column) Maternity –elective c-section rates Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus) based
Physician or physician group, 4: Other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: non-visit 9: non-visit 10: policy for specific services that 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus) based based
were or services that were 11: Other non-FFS payment reform models (describe in next column) HOSPITAL QUALITY INSTITUTE HOSPITAL ENGAGEMENT NETWORK Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus) based
specific with quality, 7: Bundled payment with quality, 8: non-visit 9: non-visit 10: policy for specific services that were or services that were 11: Other non-FFS payment reform models (describe in next column) CAUTI Multi, 1: Hospital, 2: ACO, 3: Physician or physician Multi, 1: (other than bundled and/or 65 words. Multi, 1: Hospital 2: Hospital with based
group, 4: Other with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: non-visit 9: non-visit 10: policy for specific services that were or services 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus) based based
that were 11: Other non-FFS payment reform models (describe in next column) CLABSI Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus) based
with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: non-visit 9: non-visit 10: policy for specific services that were or services that were Element for P4P or Shared Risk, 4: P4P Payment amount of bonus) based based
11: Other non-FFS payment reform models (describe in next column) Adverse drug events (ADE) Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus) based
with quality, 8: non-visit 9: non-visit 10: policy for specific services that were or services that were 11: Other non-FFS payment reform models (describe in next column) AGENCY FOR HEALTHCARE RESEARCH AND QUALITY (AHRQ)* Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or based based
payment reform models (describe in next column) Inpatient quality indicators Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus) based based
non-visit 9: non-visit 10: policy for specific services that were or services that were 11: Other non-FFS payment reform models (describe in next column) Patient safety indicators Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment based
with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: non-visit 9: non-visit 10: policy for specific services that were or services that were 11: Other non-FFS payment reform models (describe amount of bonus) based
in next column) Prevention quality indicators Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: non-visit 9: 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus) based based
non-visit 10: policy for specific services that were or services that were 11: Other non-FFS payment reform models (describe in next column) OTHER MEASURES Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment based
HACs – hospital conditions (e.g., Surgical site infection following coronary artery bypass graft Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: non-visit 9: non-visit 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus) based based
10: policy for specific services that were or services that were 11: Other non-FFS payment reform models (describe in next column) SREs (serious reportable events) that are not HACs (e.g., surgery on the wrong body part or wrong patient) www.qualityforum.org/Topics/SREs/List_of_SREs.aspx . Please refer to attachment Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus) based
1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: non-visit 9: non-visit 10: 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus) based based
were or services that were 11: Other non-FFS payment reform models (describe in next column) MORTALITY MEASURES (AMI, HF and Pneumonia mortality measures) Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus) based
specific with quality, 7: Bundled payment with quality, 8: non-visit 9: non-visit 10: policy for specific services that were or services that were 11: Other non-FFS payment reform models (describe in next column) ICU Mortality Multi, 1: Hospital, 2: ACO, 3: Physician or physician Multi, 1: (other than bundled and/or 65 words. Multi, 1: Hospital 2: Hospital with based
group, 4: Other with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: non-visit 9: non-visit 10: policy for specific services that were or services 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus) based based
that were 11: Other non-FFS payment reform models (describe in next column) HIT adoption/use Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus) based
with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: non-visit 9: non-visit 10: policy for specific services that were or services that were Element for P4P or Shared Risk, 4: P4P Payment amount of bonus) based based
11: Other non-FFS payment reform models (describe in next column) Osteoarthritis- Hospital-Level Risk-Standardized Complication Rate Following Elective Primary Total Hip Arthroplasty and/or Total Knee Arthroplasty Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus)
payment reform models (describe in next column) Low Back Pain- Use of Imaging Studies for Low Back Pain Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus)
non-visit 9: non-visit 10: policy for specific services that were or services that were 11: Other non-FFS payment reform models (describe in next column) Low Back Pain - Functional Status Change for Patients with Lumbar Impairments Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment
in next column) Rate of hospital-level observation stays Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: non-visit 9: 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus)
non-visit 10: policy for specific services that were or services that were 11: Other non-FFS payment reform models (describe in next column) Rate of use of inappropriate care (select a measure for reporting) Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment
Other standard measures endorsed by National Quality Forum (describe): Multi, 1: Hospital, 2: ACO, 3: Physician or physician group, 4: Other Multi, 1: (other than bundled and/or with quality, 2: with quality, 3: with quality, 4: FFS plus pay for 5: Full with quality, 6: Partial or specific with quality, 7: Bundled payment with quality, 8: non-visit 9: non-visit 65 words. Multi, 1: Hospital 2: Hospital with 3: Element for P4P or Shared Risk, 4: P4P Payment amount of bonus)
Groups/IPAs Groups/IPAs Groups/IPAs HOSPITAL SERVICES 5: Specialists Provide the total dollars paid to providers through traditional FFS payments in CY 2015 or most recent 12 months Dollars. N/A OK. Percent. N/A OK. Percent. N/A OK. Multi, 1: ACO, 2: PCMH, 3: Medical 4: Primary Care, 5: Specialists For comparison. Unknown Note: Percentages provided in this row do not total 100% 2 Provide the total dollars paid to providers through bundled payment programs without quality in CY 2015 or most recent 12 months Dollars. N/A OK. Percent. N/A OK. Percent. N/A OK. Multi, 1: ACO, 2: PCMH, 3: Medical 4: Primary Care, 5: Specialists For comparison. Unknown Note: Percentages provided in this row do not total 100% 3 Provide the total dollars paid to providers through partial or Dollars. N/A OK. Percent. N/A OK. Percent. N/A OK. Multi, 1: ACO, 2: PCMH, 3: Medical 4: Primary Care, For comparison. Unknown Note: Percentages provided in this row do 4
Groups/IPAs Groups/IPAs capitation programs without quality in CY 2015 or most recent 12 months 5: Specialists not total 100% Provide the total dollars paid to providers through fully capitated programs without quality in CY 2015 or most recent 12 months Dollars. N/A OK. Percent. N/A OK. Percent. N/A OK. Multi, 1: ACO, 2: PCMH, 3: Medical 4: Primary Care, 5: Specialists For comparison. Unknown Note: Percentages provided in this row do not total 100% 5 Subtotal: Dollars paid out under the status quo: total dollars paid through traditional payment methods in CY 2015 for hospital services [Sum of Rows 2, 3 4 and 5] For comparison. $0.00 Percent. Percent. Multi, 1: ACO, 2: PCMH, 3: Medical 4: Primary Care, 5: Specialists For comparison. Unknown Note: Percentages provided in this row do not total 100% 6
Groups/IPAs Groups/IPAs Groups/IPAs Provide the total dollars paid to providers through shared-risk programs with quality in CY 2015 or most recent 12 months Dollars. N/A OK. From 0 to Percent. N/A OK. Percent. N/A OK. Multi, 1: ACO, 2: PCMH, 3: Medical 4: Primary Care, 5: Specialists For comparison. Unknown Note: Percentages provided in this row do not total 100% 7 Provide the total dollars paid to providers through FFS-based programs with quality in CY 2015 or most recent 12 months Dollars. N/A OK. From 0 to Percent. N/A OK. Percent. N/A OK. Multi, 1: ACO, 2: PCMH, 3: Medical 4: Primary Care, 5: Specialists For comparison. Unknown Note: Percentages provided in this row do not total 100% 8 Provide the total dollars paid to providers through Dollars. N/A OK. From 0 to Percent. N/A OK. Percent. N/A OK. Multi, 1: ACO, 2: PCMH, 3: Medical 4: Primary Care, For comparison. Unknown Note: Percentages provided in this row do 9
Groups/IPAs Groups/IPAs programs with quality CY 2015 or most recent 12 months. 5: Specialists not total 100% Provide the total dollars paid to providers through FFS base payments plus (P4P) programs CY 2015 or most recent 12 months Dollars. N/A OK. From 0 to Percent. N/A OK. Percent. N/A OK. Multi, 1: ACO, 2: PCMH, 3: Medical 4: Primary Care, 5: Specialists For comparison. Unknown Note: Percentages provided in this row do not total 100% 10 Provide the total dollars paid to providers through fully capitated payment with quality in CY 2015 or most recent 12 months. Dollars. N/A OK. From 0 to Percent. N/A OK. Percent. N/A OK. Multi, 1: ACO, 2: PCMH, 3: Medical 4: Primary Care, 5: Specialists For comparison. Unknown Note: Percentages provided in this row do not total 100% 11
Groups/IPAs Groups/IPAs Groups/IPAs Provide the total dollars paid to providers through partial or capitation programs with quality in CY 2015 or most recent 12 months Dollars. N/A OK. From 0 to Percent. N/A OK. Percent. N/A OK. Multi, 1: ACO, 2: PCMH, 3: Medical 4: Primary Care, 5: Specialists For comparison. Unknown Note: Percentages provided in this row do not total 100% 12 Provide the total dollars paid to providers through bundled payment programs with quality CY 2015 or most recent 12 months Dollars. N/A OK. From 0 to Percent. N/A OK. Percent. N/A OK. Multi, 1: ACO, 2: PCMH, 3: Medical 4: Primary Care, 5: Specialists For comparison. Unknown Note: Percentages provided in this row do not total 100% 13 Provide the total dollars paid for Dollars. N/A OK. From 0 to Percent. N/A OK. Percent. N/A OK. Multi, 1: ACO, 2: PCMH, 3: Medical For comparison. Unknown Note: Percentages provided in 14
Groups/IPAs Groups/IPAs functions. (see definitions for examples) in CY 2015 or most recent 12 months. 4: Primary Care, 5: Specialists this row do not total 100% Provide the total dollars paid for non-visit functions. (see definitions for examples) in CY 2015 or most recent 12 months. Dollars. N/A OK. From 0 to Percent. N/A OK. Percent. N/A OK. Multi, 1: ACO, 2: PCMH, 3: Medical 4: Primary Care, 5: Specialists For comparison. Unknown Note: Percentages provided in this row do not total 100% 15 Provide the total dollars paid to providers whose contract contains other types of incentive program not captured above and NOT on FFS Dollars. N/A OK. From 0 to Percent. N/A OK. Percent. N/A OK. Multi, 1: ACO, 2: PCMH, 3: Medical 4: Primary Care, 5: Specialists For comparison. Unknown Note: Percentages provided in this row do not total 100% 16