Show:
The 4 P's
Do You Cozeva?
High on the Hill
Didn't Know That!
Checking Your Work
100
Name 1 of 6 Payable clinical measures for Commercial Adults.
(1) Avoidance of Antibiotic Treatment with Acute Bronchitis (2) Breast Cancer Screening (3) Chlamydia Screening (4) Controlling Blood Pressure for People with Hypertension (5) Diabetes Care-2 HbA1c Tests (6) Optimal Diabetes Care
100
True/False— Cozeva displays only Payable clinical measures for P4.
True
100
Which of the below is in the right descending order of membership volume (A) HMO Commercial, Medi-Cal, Medicare, PPO (B) HMO Commercial, Medi-Cal, PPO, Medicare (C) HMO Commercial, PPO ,Medicare, Medi-Cal (D) HMO Commercial, Medicare, Medi-Cal, PPO
(B) HMO Commercial, Medi-Cal, PPO, Medicare
100
When are the Auth, Claims, and Eligiblity cubes updated (i.e., refreshed)?
Auth (Daily around 10AM) Claims (Weekly on Sunday) Eligibility (Weekly on Saturday)
100
What is the "sniff" test?
Fact checking data and/or results to other references and previous reports; a basic questioning of the feasibility.
200
P4 uses what lines of business?
(1) Commercial Adults (2) Commercial Pediatric (3) Medicare
200
Demonstrate how to look up Sockolov & Sockolov’s Q2 2016 P4 results.
Use Cozeva.
200
Which of the below IS NOT a source of revenue for Hill? (A) HMO Commercial capitation (B) Medicare Advantage (C) Health Plan Quality Revenue (D) PPO capitation (E) Managed Medi-Cal
(D) PPO capitation
200
Informatics use how many applications?
~ 9 IDX; Access Express; Vistar; QNXT; Cozeva; SSRS; Excel- VBA; SAS; SQL Server
200
Which chart IS NOT recommended when presenting data visually? (1) Line graphs (2) 3D graphs (3) Bar and histogram graphs (4) Pie charts with multiple variables
(2) 3D graphs (4) Pie charts with multiple variables
300
What does P4 stand for?
Physician Performance Payment Program
300
Demonstrate how to look up a member’s latest blood pressure reading.
Use Cozeva.
300
Which of the 5 regions is the second largest, containing all product types (i.e, Commercial, Medicare, Exchange, Medi-Cal, etc)?
(2) San Francisco- 50,190 (1) Sacramento- 132,914 (3) San Joaquin- 42,381 (4) East Bay- 36,339 (5) Solano- 3,362 ** Month ending Sep2016
300
What reports do Informatics support and post on its webpage?
(1) Facility ER Utilization (2) Provider ER utilization, Membership, Specialty cost summary, YTD dashboard (3) Membership Reporting (4) Pharmacy Reports (5) ACO reports (6) Other reports are Provider Portal Review
300
When doing a report, what general questions should you ask the requester?
(1) What's the business question? (2) How will the answer be used? (3) What specific criteria should be used?
400
What is a “Watch” category?
A "Watch" category contains metrics that are significant to the Hill Physicians network and, in Hill Physicians’ reasonable discretion, could be deemed to be a Payment Metric, as appropriate.
400
What programs, other than P4, are selection options in Cozeva?
(1) IHA Commercial/Medicare (2) Medicare (3) Medi-Cal (4) All of the above, including P4
400
HPMG's new CIO, Umang Jain, came from which health plan?
Blue Shield of California
400
Which of the following Hill Case Management DOES NOT address? (A) Medication (B) Food and shelter (C) Health Education (D) Transportation (E) Treatment
(E) Treatment
400
True/False- No need to call out what's obvious in the report.
False
500
P4 uses what external benchmarks for clinical measures’ Targets and minimum thresholds?
Commercial (Adults and Children)— IHA percentiles Medicare— CMS Stars Program Thresholds
500
What is the meaning of Cozeva?
In French, “Coze” means "to chat in a friendly manner" and "va" is the Latin root word for "go/move." Taken together, coze+va, “Cozeva,” conveys the inner spirit in ARW which is to communicate and move people toward health and wellness.
500
What award did HPMG recently earn?
IHA Award Winner, Achieving Quality Metrics The Integrated Healthcare Association announced that the Sacramento region won the prestigious Value-Based P4P Excellence in Healthcare performance award for measurement year 2015! Of the 200-plus physician organizations statewide participating in the Value Based P4P program, only 34 attained the Excellence in Healthcare Award performance standards. Hill Physicians demonstrated a 2.5% improvement overall across the clinical quality metrics, representing 6,000+ additional compliant patients.
500
Access Express is an application used for entering which of the following? (A) Inpatient data (B) Authorizations (C) Attestations (D) Case Management
(B) Authorizations (D) Case Management
500
Who is the #1 SME for Excel VBA? (1) Jeff (2) John (3) Hopil (4) Caitlin
(3) Hopil