Does Applicant routinely subcontract any significant portion of your operations or partner with other companies to provide health plan coverage? If yes, identify which operations are performed by subcontractor or partner and provide the name of the subcontractor. Billing, invoice, and collection activities □ Yes □ No Database and/or enrollment transactions □ Yes □ No Claims processing and invoicing □ Yes □ No Membership/customer service □ Yes □ No Welcome package (ID cards, member communications, etc.) □ Yes □ No Other (specify) □ Yes □ No Are any of Applicant’s operations, such as member services call centers, conducted outside of the United States? If yes, describe the operations. □ Yes □ No Submit a copy of business continuity plans in event of an emergency or disruption of services to Exchange members. Applicant must include an organizational chart of key personnel who will be assigned to Covered California. The Key Personnel and representatives of the Account Management Team who will be assigned to Covered California must be identified in the following areas: Executive Finance Operations Contracts Plan and Benefit Design Network and Quality
COE for NCQA HMO Single, Pull-down list. 1: Excellent, 2: 3: 4: 5: Interim, 6: Denied, 7: NCQA not used or product not eligible NCQA Wellness & Health Promotion Single, group. 1: Accredited and Reporting Measures to NCQA, 2: Accredited and NOT reporting measures, 3: Did not participate NCQA Disease – Multi, 1: Patient and oriented, 2: Patient PHQ )
MHC Distinction URAC Multi, - optional. 1: URAC not used URAC - Health Plan Single, Radio group. 1: URAC 2: Not URAC Accredited URAC - Wellness Single, Radio group. 1: URAC 2: Not URAC Accredited URAC - Disease Single, group. 1: URAC 2: Not URAC Accredited URAC - Health Utilization Single, Radio group. 1: URAC 2: Not URAC Accredited , , , ,
NCQA PPO Single, Pull-down list. 1: Excellent, 2: 3: 4: 5: Interim, 6: Denied, 7: NCQA not used or product not eligible NCQA Wellness & Health Promotion Single, Radio group. 1: Accredited and Reporting Measures to NCQA, 2: Accredited and NOT reporting measures, 3: Did not participate NCQA Disease – Multi, 1: Patient and oriented, 2: Patient oriented, 3: Plan )
Oriented, 4: NCQA not used NCQA Disease – Multi, 1: Program Design, 2: Systems, 3: Contact, 4: NCQA not used NCQA Case Single, Radio group. 1: Accredited - 3 years, 2: Accredited - 2 years, 3: No NCQA PHQ Single, Pull-down list. 1: Certified, 2: No PHQ NCQA Health Care Distinction Single, Pull-down list. 1: 2: No MHC Distinction
URAC Multi, - optional. 1: URAC not used URAC - Health Plan Single, Radio group. 1: URAC 2: Not URAC Accredited URAC - Wellness Single, Radio group. 1: URAC 2: Not URAC Accredited URAC - Disease Single, Radio group. 1: URAC 2: Not URAC Accredited URAC - Health Utilization Single, group. 1: URAC 2: Not URAC Accredited URAC - Case Single, Radio group. 1: URAC
8.4.2 Reducing Health Disparities and Assuring Health Equity Describe how the health plan collects and uses data on race, ethnicity, gender, disability status, gender identity, and sexual orientation. 8.4.2.1 Identify the sources of information used to gather members' demographic information. The response “Enrollment Form” pertains only to information reported directly by members (or as passed on by CalHEERS about specific Covered California members). In the last two columns, as this is not a region/market specific question, please provide the statewide % for all members and all Covered California members captured across all products. Data collected from all new California enrollees (specify date started - How data is captured about both new membership and members enrolled before data was proactively collected for whom data is as a percent of total Covered for whom data is captured as percent of total Covered Race/ethnicity To the day. N/A OK. From 10/01/13 to 12/31/14. Multi, Checkboxes. 1: Enrollment form, 2: Health Assessment, 3: Information requested upon Website registration, 4: Inquiry upon call to Customer Service, 5: Inquiry upon call to Clinical Service line, 6: Imputed method - zip code Percent. member capture
QC - Total to to NO 8.4.5.16 Which of the following member interventions applying to at least 75% of your enrolled membership were used by the Plan in calendar year 2015 to improve cancer screening rates? Indicate all that apply. Educational messages identifying screening options discussing and benefits Member-specific reminders (electronic or written, etc.) sent to members for needed care based on general eligibility (age/gender) Member-specific reminders for gaps in services based on administrative or clinical information (mail, e-mail/text, automated phone or live outbound telephone calls triggered by the ABSENCE of a service) 100 100
payments, discounts for consumer goods, etc.) administered independently of medical services and contingent upon completion/participation, 4: Not supported Participation in weight-loss program (exercise and/or diet/nutrition) (As above) (As above) (As above) Success in weight-loss or maintenance (As (As (As above) Participation in tobacco cessation (As above) (As above) (As above) Success with tobacco cessation goals (As above) (As above) (As above) Participation in wellness health coaching (As above) (As above) (As above) Success with wellness goals other than weight-loss and tobacco cessation (As above) (As above) (As above) Incentives not contingent on participation or completion Well child & adolescent care Multi, Checkboxes. 1: Waive/adjust payments for tests, treatments, Rx, 2: Part of program with reduced Premium Share, 3: Rewards (cash Percent. N/A OK. From 0 to 100. Yes/No.
Participation in weight-loss program (exercise and/or diet/nutrition) (As (As above) (As Success in weight-loss or maintenance (As above) (As above) (As above) Participation in tobacco cessation (As above) (As above) (As above) Success with tobacco cessation goals (As (As above) (As above) Participation in wellness health coaching (As above) (As above) (As above) Success with wellness goals other than weight-loss and tobacco cessation (As above) (As above) (As above) Incentives not contingent on participation or completion Well child & adolescent care Multi, Checkboxes. 1: Waive/adjust payments for tests, treatments, Rx, 2: Part of program with reduced Premium Share, 3: Rewards (cash payments, discounts for consumer goods, etc.) administered independently of medical services, 4: Not supported Percent. N/A OK. From 0 to 100. Yes/No.
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.
Online interactive self-management support. "Online self-management support" is an intervention that includes two-way electronic communication between the Health plan and the member. Examples include devices that monitor weight, lab levels, etc. as well as activities that are customized and tailored based on the member's health status/risk factors. Interactive implies a response mechanism that results in calibration of subsequent interventions. This category does not include searchable static web information. (Documentation needed) 1: 2: PPO, 3: not 4: 5: 6: but not or Decimal. From 0 to Multi, 1: Low, 2: 3: High risk, 4: No Self-initiated text/email messaging (As (As above) (As (As (As Interactive IVR with information capture Answer “Interactive IVR (As (As above) (As (As (As
of as in 1, 2 3 to in this California members 18 years and above in this receiving (if Health plan offers but does not track enter zero) that this % of who % of plan who Number of members aged 18 and above in this market Using the NCQA “Eligible Population” definition for Diabetes in the 2015 HEDIS Technical Specifications Vol 3., provide number of members 18 and above with Diabetes Using the plan's own criteria, provide number of members identified with condition and eligible to participate in be
diabetes DM program General member education (e.g., newsletters) Multi, 1: 2: PPO, 3: not Decimal. From 0 to 1: Low, 2: 3: High risk, 4: No General care on condition alone (e.g., personalized letter) (As (As above) (As (As (As Member-specific reminders for due or overdue clinical/diagnostic maintenance services Answer reminders” only if it involves reminders that are independent of the live outbound telephonic program (Documentation needed) (As (As above) (As (As (As Member-specific reminders for medication events (e.g., level of use, (As (As above) (As (As (As
(Documentation needed) or Self-initiated text/email messaging (As (As above) (As (As (As Interactive IVR with information capture. Answer “Interactive IVR with information capture” only if it involves information capture of member response information for record updates and/or triggering additional intervention. (As (As above) (As (As (As IVR with outbound messaging only (As (As above) (As (As (As Live outbound telephonic coaching program (count only members that are successfully engaged) Multi, 2: PPO, 3: not (As (As (As (As 8.4.9.6 Review the two most recently uploaded of HEDIS results for the Plan HMO product based on QC 2015 and QC 2014.
risk segmentation. Enter “Zero” if the intervention is not provided to members with Asthma. Select “Interactive IVR with information capture” only if it involves record updates and/or triggering additional intervention. Select “member-specific reminders” only if it involves reminders that are independent of the live outbound telephonic program. Select online interactive self management only if the application involves customized information based on branch logic. Interactive implies a response mechanism that results in calibration of subsequent interventions. This category does not include static web information. A member is “actively engaged” in the outbound telephonic program if they participate beyond the initial coaching call. For member counts use the number of members as of December 31who participated in the activity at any time during the applicable calendar year. of as in 1, 2 3 if to in this Number of California members 5 and above in this receiving (if Health plan offers but does not track enter zero) Risk strata that this % of who % of plan who Number of members aged 5 and above in this market Using the NCQA “Eligible Population” definition for Asthma in the 2015 HEDIS Technical be
health status/risk factors. Interactive implies a response mechanism that results in calibration of subsequent interventions. This category does not include searchable static web information. (Documentation needed) 5: 6: but not or Self-initiated text/email messaging (As (As above) (As (As (As Interactive IVR with information Answer “Interactive IVR with information capture” only if it involves information capture of member response information for record updates and/or triggering additional intervention. (As (As (As (As (As IVR with outbound messaging only (As (As above) (As (As (As Live outbound telephonic coaching program (count only members that are Multi, 1: (As above) (As (As (As
enter NA) Number of members aged 18 and above in this market Using the Plan’s definition, provide number of members 18 and above who are High Risk Medically Complex reminders for due or overdue maintenance services Answer reminders” only if it involves reminders that are independent of the live outbound telephonic program Multi, 1: HMO, 2: PPO, 3: not offered, 4: Number 5: National Number 6: Offered but not tracked Decimal. From 0 to Multi, 1: as part of program with no fee, 2: of this requires an fee, 3: of this requires Unknown
members that are successfully engaged) visits 8.4.9.14 If the Health plan indicates that it monitors services for gaps in CAD, diabetes and/or asthma in questions above, indicate which services are monitored. If the “other” choice is selected, describe the service that is monitored in the text box. The Health plan can also use this text box to describe their general approach to reminders, such as criteria to distinguish which members are given member-specific reminders. Data Source in general, not per service Multi, 1: Blood levels, 2: Beta Blocker Use, 3: LDL testing, 4: LDL control, 5: Aspirin therapy, 6: Gaps in Rx fills, 7: Other, 8: Not Multi, 1: Medical records, 2: Claim feed, 3: RX Data Feed, 4: Vendor feed (lab, 5: Patient 6: Patient home
Multi, 1: Retinal Exam, 2: LDL Testing, 3: LDL Control, 4: Foot exams, 5: testing, 6: HbA1c Control, 7: Blood 8: Blood 9: Gaps in Rx fills, 10: Other, 11: Not Multi, 1: Medical records, 2: Claim feed, 3: RX Data Feed, 4: Vendor feed (lab, 5: Patient 6: Patient home 1: of asthma 2: Multi, 1: Medical records, 2: Claim feed, 3: RX Data Feed, 4: Vendor
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)
using plan entered enrollment as Number of unique users to physician directory portion of site of unique users to total enrollment using plan entered enrollment as For 0.00% For 0.00% Measuring change in use of physicians Multi, 1: PCP 2: Volume of 3: Paid claims, 4: Not Multi, 1: PCP 2: Volume of 3: Paid claims, 4: Not Targeted follow up via email Single, Radio group. Single, Radio group.
users to site of unique users to total For 0.00% For 0.00% follow up via email or phone call to assess user Single, Radio group. N/A OK. 1: Yes, 2: No Single, Radio group. N/A OK. 1: Yes, 2: No use and/or volume of at Multi, N/A OK. 1: Volume of 2: Paid claims N/A OK. 1: Volume of 2: Paid claims use and/or volume of at Centers of Plan can report Single, Radio group. N/A OK. Single, Radio group. N/A OK.
Annual electrocardiograms (EKGs) or any cardiac screening for low-risk patients without symptoms (As above) (As Stress cardiac imaging or advanced imaging in the initial evaluation of patients without cardiac symptoms unless high-risk markers are present (As above) (As Annual stress cardiac imaging or advanced non-invasive imaging as part of routine follow-up in asymptomatic patients (As above) (As Stress cardiac imaging or advanced imaging as a pre-operative assessment in patients scheduled to undergo low-risk non-cardiac surgery (As above) (As Echocardiography as routine follow-up for mild, asymptomatic native valve disease in adult patients with no change in signs or symptoms (As above) (As Stenting of non-culprit lesions during percutaneous coronary intervention (PCI) for uncomplicated hemodynamically stable ST-segment elevation myocardial infarction (STEMI) (As above) (As 8.4.12 Value Based Reimbursement Inventory and Value Pricing Programs 8.4.12.1 Indicate if the following elements are applied when determining eligibility of measures for assessment, public reporting and payment rewards. Purchasers expect health plans to comply with the Consumer-Purchaser Disclosure Project "Patient Charter" for Physician Performance Measurement, Reporting and Tiering Programs (available at .) 1: Measures are nationally standardized, 2: Defined clinical specifications, 3: Methodology for attributing patients to physicians, practice sites or medical group/IPAs, 4: Minimum number of observations, 5: Statistical significance test or confidence interval when reporting performance differences, 6: Case mix or severity adjustment, 7: Geographic adjustment to determine peer group average, 8: Handling of outlier cases in measurement of cost or resource use,
Program 1 Other markets/details for Program 1 Repeat for 2-5 Name of Payment Reform Program 65 N/A Contact Name for Payment Reform Program (person who can answer questions about the program being described) 5 words. N/A Contact Person's (As above) (As Contact Person's Email (As (As above) Contact Person's Phone (As above) (As above) Contact Name for person who is authorized to update this program entry in ProposalTech after Health plan has submitted response (if same as contact name for the payment reform program, please his/her name) (As above) (As above) Email for person authorized to update this program entry in ProposalTech after Health plan has submitted response (if same as contact email for the payment reform (As above) (As
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
8: FFS-based non-visit functions, 9: Non-FFS-based functions, 10: Non-payment for specific services associated with HACs (healthcare acquired conditions also known as hospital-acquired conditions) that were preventable or services that were unnecessary, 11: Other non-FFS based payment reform models (provide details in next column) Which base payment methodology does your program use? Single, Radio group. 1: Capitation without quality, 2: Salary, 3: Bundled or payment without quality, 4: FFS (includes discounted fees, fixed fees, indexed fees), 5: Per diem, 6: DRG, 7: Percent of charges, 8: Other - (provide details in next column) 50 What types of providers are participating in your program? Multi, Checkboxes. 1: Primary care physicians, 2: Physician Specialists (e.g., Oncology, Cardiology, etc.) – describe in next column, 3: RNs/NP and other non-physician providers, 4: Hospital inpatient, 5: Other - (provide details in next column) 50 words. If you have a payment reform that includes policies on Multi, Checkboxes. 1: N/A, 2: Ambulatory care sensitive admissions, 65 words.
Percent HOSPITAL CHARGE) Total $ Paid in the applicable Calendar Year or most current 12 months (Estimate breakout of amount in this column into percentage by entity paid in next 3 columns) listed of dollar listed in 1 for each row) listed below of dollar listed in 1 for each row) IPAs) paid listed below of dollar amount listed in column 1 for each row) is % listed in 4 are paid 1. = total $ in row 1 column 1 = $ in specific row C1 IN-NETWORK dollars paid for to Providers for ALL commercial members FOR ALL OUTPATIENT SERVICES (i.e., services for which there is NO ASSOCIATED HOSPITAL CHARGE) Dollars. Percent. Multi, 1: ACO, 2: 3: For Note: in this row do not total 100% Provide the dollars paid to providers through traditional FFS payments in the applicable calendar year or most recent 12 months (As above) (As (As (As above) (As (As above)
Program 1 Other markets/details for Program 1 repeat for 2-5 Name of Payment Reform Program and Name and contact details (email and phone) of contact person who can answer questions about program being described 65 words. N/A Contact Name for Payment Reform Program (person who can answer questions about the program being described) 5 words. N/A Contact Person's Title (As above) (As above) Contact Person's Email (As above) (As Contact Person's (As above) (As above) Contact Name for person who is authorized to update this program entry in ProposalTech after Health plan has submitted response (if same as contact name for the payment reform program, please his/her name) (As above) (As above) Email for person authorized to update this program entry in (As above) (As above)
917, 918, and 935, 16: Los Angeles County ZIP Codes in other than those identified above, 17: San Bernardino and Riverside, 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 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 What is current of implementation? Provide date of implementation in detail column Single, Radio 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 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 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, 65 words.
5: Other - (provide details in next column) If you have a payment reform model that includes policies on for specific services associated with complications that were preventable or services that were unnecessary, for which outcomes are these policies in place? Multi, Checkboxes. 1: N/A, 2: Ambulatory care sensitive admissions, 3: Healthcare acquired conditions (HACs) also known as conditions, 4: Preventable Admissions, 5: Serious Reportable Events (SREs) that are not HACs, 6: Never Events, 7: Early elective induction or cesarean, 8: Other - (provide details in next column) 65 words. Which of the following sets of performance measures does your program use? Multi, Checkboxes. 1: Achievement (relative to target or peers) of Clinical process goals (e.g., prophylactic antibiotic administration, timeliness of medication administration, testing, screenings), 2: Achievement (relative to target or peers) of Clinical outcomes goals(e.g., readmission rate, mortality rate, A1c, cholesterol values under control), 3: Improvement over time of NQF-endorsed Outcomes and/or Process measures, 4: PATIENT SAFETY (e.g., Leapfrog, AHRQ, medication related safety issues), 5: Appropriate maternity care, 6: Longitudinal efficiency relative to target or peers, 50 words.
$ Paid in the applicable Calendar Year or most current 12 months Estimate breakout of amount in this column into percentage by contracted entity paid in next 2 columns listed of dollar listed in 1 for each row paid under listed payment category below Estimated of dollar amount listed in column 1 for each row listed in column 3 Please select which contracted entities are paid in column 3 in column 1. = total $ in row 1 column 1 = $ in specific row C1 Total IN-NETWORK dollars paid for to Providers for ALL commercial members for HOSPITAL SERVICES Dollars. Percent. Multi, 1: ACO, 2: PCMH, 3: Medical 4: Primary Care, 5: Specialists For Note: provided in this row do not total 100% Provide the total dollars paid to providers through traditional FFS payments in the applicable calendar year or most recent 12 months (As above) (As (As above) (As (As Provide the total dollars paid to providers through bundled payment programs without quality components in the (As above) (As (As (As above) (As
Maternity Services Payment Reform Response Provide the total dollars paid to hospitals for maternity care for the applicable calendar year or most current 12 months with sufficient Dollars. N/A OK. Provide the dollars paid for maternity care to hospitals with contracts that include incentives to adhere to clinical guidelines, which, if followed, would reduce elective medical intervention during labor and delivery in the past year. Such Dollars. N/A OK. From 0 to
HMO HQA MYOCARDIAL INFARCTION (AMI) 1: 2: PPO, 3: Both HMO and PPO, 4: EPO only 5: All 6: Not Multi, 1: 2: ACO, 3: or 4: Other Checkboxes. 1: Shared-risk (other than bundled payment) and/or gainsharing with quality, 2: FFS-based with quality, 3: Non-FFS-based with quality, 4: FFS plus pay for performance, 5: Full capitation with quality, 6: Partial or condition specific capitation with quality, 7: Bundled payment with quality, 8: FFS-based non-visit functions, 9: Non-FFS-based non-visit functions, 10: Non-payment policy for specific services associated with hospital-acquired conditions that were preventable or services that were unnecessary, 11: Other non-FFS based payment reform models (describe in next column) 65 N/A OK. N/A OK. HEART FAILURE (HF) (As (As (As above) (As (As (As PNEUMONIA (PNE) (As (As (As above) (As (As (As SURGICAL INFECTION PREVENTION (SIP) (As (As (As above) (As (As (As Surgical Care Improvement Project (SCIP) (As (As (As above) (As (As (As
Surgical site infections (SSI) (As (As (As above) (As (As (As Adverse drug events (ADE) (As (As (As (As (As (As AGENCY FOR HEALTHCARE RESEARCH AND (AHRQ)* (As (As (As (As (As (As Inpatient quality indicators (As (As (As above) (As (As (As Patient safety indicators (As (As (As above) (As (As (As Prevention quality indicators (As (As (As above) (As (As (As MEASURES (As (As (As above) (As (As (As HACs – hospital acquired conditions (e.g., Surgical site infection following coronary artery bypass graft (As (As (As above) (As (As (As SREs (serious reportable events) that are not HACs (e.g., surgery on the wrong body part or wrong (As (As (As above) (As (As (As
Aim 3. (add other aims as 9.2.7 Patient-Centered Information and Support Federal QIS Topic Area: Activities for improving health outcomes 2017 QHP Issuer Contract, Sections 7.01 Aim(s) Change Concept(s)/ Objective(s) Data Sources Target date for achieving goal(s) Aim 1. Aim 2. Aim 3. (add other aims as 9.3 Implementation Plans and Baseline Data for Quality Improvement Strategy (QIS) for Covered California Quality and Delivery System Reform – Year One Refer to “Appendix H_Initiative Contract Requirements” for all requirements related to each initiative area. 9.3.1 QIS for Provider Networks Based on Quality Federal QIS Topic Area: Activities to improve patient safety and reduce medical errors 2017 QHP Issuer Contract, Section 1.02