Code | Display | Comments |
---|
avg-risk-score | Average risk score | |
avg-risk-score-market | Market average risk score | |
capitation | Capitation | |
capitation-pmpm | Capitation per member per month | |
dental-capitation | Dental capitation | |
dental-capitation-pmpm | Dental capitation PMPM | |
reinsurance-capitation | Reinsurance capitation | |
reinsurance-capitation-pmpm | Reinsurance capitation PMPM | |
ccf | Care coordination fee | |
goal-hcc-raf | Goal HCC RAF | |
actual-hcc-raf | Actual HCC RAF | |
earnings-ccf | Earnings CCF | |
performance-ccf | Performance CCF | |
potential-upside-ccf | Potential upside CCF | |
potential-downside-ccf | Potential downside CCF | |
earned-incentive | Earned incentive | |
earnings-qip | Earnings QIP | |
performance-qip | Performance QIP | |
potential-upside-qip | Potential upside QIP | |
potential-downside-qip | Potential downside QIP | |
earnings-ssl | Earnings SSL | |
performance-ssl | performance SSL | |
potential-upside-ssl | Potential upside SSL | |
potential-downside-ssl | potential downside SSL | |
earnings-cap | Earnings capitated | |
performance-cap | Performance capitated | |
potential-upside-cap | Potential upside capitated | |
potential-downside-cap | Potential downside capitated | |
quality-gate-percentage | Quality gate percentage | |
quality-gate-performance-percentage | Quality gate performance percentage | |
interim-pmt-rate | Interim payment rate | |
ibnr-pmpm | IBNR PMPM | |
med-ibnr | Medical IBNR | |
rx-ibnr | Pharmacy IBNR | |
med-rx-ibnr | Medical pharmacy IBNR | |
revenue | Revenue | |
revenue-pmpm | Revenue PMPM | |
avg-revenue-pmpm-market | Market average revenue PMPM | |
cost-target | Cost target | |
admin-cost | Administrative cost | |
rx-cost | Pharmacy cost | |
rx-cost-target | Pharmacy cost target | |
rx-cost-pmpm | Pharmacy cost PMPM | |
rx-cost-pmpm-target | Pharmacy cost PMPM target | |
med-cost | Medical cost | |
med-cost-target | Medical cost target | |
med-cost-pmpm | Medical cost PMPM | |
med-cost-pmpm-target | Medical cost PMPM target | |
med-cost-fund | Medical cost fund | |
avg-med-cost-fund-market | Market average medical cost fund | |
med-rx-cost | Medical pharmacy cost | |
med-rx-cost-target | Medical pharmacy cost target | |
med-rx-cost-pmpm | Medical pharmacy cost PMPM | |
avg-med-rx-cost-pmpm-market | Market average medical pharmacy cost PMPM | |
variance-cost | Variance cost | |
med-loss-ratio | Medical loss ratio | |
med-loss-ratio-target | Medical loss ratio target | |
med-expense-ratio | Medical expense ratio | |
med-expense-ratio-pmpm | Medical expense ratio PMPM | |
member-months | Member months | |
med-member-months | Medical member months | |
rx-member-months | Pharmacy member months | |
adjusted-paid-claim | Adjusted paid claim | |
annual-care-visit-bonus | Annual care visit bonus | |
avg-star-rating-bonus | Average star rating bonus | |
avg-star-rating-improvement-bonus | Average star rating improvement bonus | |
quality-metric-performance-incentive | Quality metric performance incentive | |
quality-pmt-chronic | Quality payment chronic disease management | |
quality-pmt-office-visit | Quality payment annual office visit | |
shared-saving-deficit | Shared saving deficit | |
weighted-avg-star | Weighted average star | |
condition-count | Condition count | |
1-gap-closed | 1 gap closed | |
2-gap-closed | 2 gaps closed | |
paid-claim | Paid claim | |
paid-claim-pmpm | Paid claim PMPM | |
drg-expense | DRG expense | |
drg-expense-pmpm | DRG expense PMPM | |
provider-quality-expense-pmpm | Provider quality expense PMPM | |
subrogation-pmpm | Subrogation PMPM | |
avg-member-office-visit | Average members with office visit | |
ed-visit | ED visit | |
eligible-member | Eligible members | |
inpatient-acute | Inpatient acute | |
inpatient-admission | Inpatient admission | |
nurse-hotline | Nurse hotline | |
nurse-hotline-pmpm | Nurse hotline PMPM | |
snf-avg-los | Skilled Nursing Facility average length of stay | |
readmission | Readmission | |
snf-admission | Skilled Nursing Facility admission | |
provider-quality-expense | Provider quality expense | |
subrogation | Subrogation | |
avg-membership | Average membership | |