Care-Based Incentive (CBI) Summary

Qhov Kev Pabcuam Central California Alliance for Health's Care-Based Incentive (CBI) muaj cov txheej txheem los txhawb kev tiv thaiv kev noj qab haus huv thiab txuas Medi-Cal cov tswv cuab nrog lawv tus kws kho mob thawj zaug (PCP).

Qhov CBI Program muaj cov Kev Pab Cuam Tshuam uas tau them rau cov chaw muab kev cog lus tsim nyog, suav nrog kev coj ua hauv tsev neeg, kev kho menyuam yaus thiab tshuaj kho mob sab hauv. Cov kev txhawb siab rau tus kws kho mob tau muab faib ua:

Programmatic kev ntsuas uas tau them txhua xyoo raws li lawv qhov kev ua tau zoo hauv txhua qhov kev ntsuas.
Fee-For-Service (FFS) kev ntsuas uas tau them txhua lub hlis twg thaum qhov kev pabcuam tshwj xeeb raug ua, lossis kev ntsuas tau ua tiav.

Lub Alliance tseem muaj kev txhawb siab rau cov tswv cuab los ntawm cov Kev Pab Txhawb Kev Noj Qab Haus Huv, uas yog them ncaj qha rau cov tswv cuab. Cov tswv cuab tsim nyog tau txais cov kev txhawb siab no yog tias lawv tau cuv npe nrog Medi-Cal los ntawm Alliance. Cov ntaub ntawv ntxiv txog kev txhawb siab rau cov tswv cuab tuaj yeem nrhiav tau ntawm Health Rewards web page.

Cov ntsiab lus txhawb siab no muab cov ntsiab lus ntawm CBI program. Yog xav paub ntxiv txog kev them nyiaj txhawb siab rau tus neeg muab kev pab saib mus rau hauv CBI Programmatic Measure Benchmarks & Performance Improvement thiab cov Alliance Provider Phau Ntawv Qhia. Yog xav paub ntxiv txog CBI Program, xa mus rau qhov kev pab cuam xyoo tshwj xeeb 2023 thiab 2024 CBI Technical Specifications. Rau cov lus nug dav dav, tham nrog koj Tus Neeg Saib Xyuas Kev Sib Raug Zoo lossis hu rau Chaw Pabcuam ntawm (800) 700-3874 ext. 5504 ib.

2024 Summary of Changes

Tshiab Programmatic Measures:

Kev Ntsuam Xyuas Lead Hauv Cov Me Nyuam: Qhov kev ntsuas no tau txav los ntawm kev tshawb nrhiav mus rau qhov kev ntsuas ntsuas.

Cov Nqi Them Tshiab-Rau-Service (FFS) Kev Ntsuas:

Diagnostic Accuracy thiab Completeness Training.
Cognitive Health Assessment Training and Attestation.
Social Determinants of Health (SDOH) ICD-10 Z-Code Xa.
Kev Txhim Kho Kev Ua Haujlwm Zoo

Kev ntsuas kev hloov:

Kev ntsuam xyuas kev noj qab haus huv thawj zaug tau raug hloov mus rau Kev teem caij noj qab haus huv thawj zaug.
Kev Ntsuam Xyuas Kev Nyuaj Siab thiab Kev Npaj Ua raws li tau hloov mus rau Kev Ntsuam Xyuas Kev Nyuaj Siab rau Cov Hluas thiab Cov Neeg Laus.
Kev Ntsuas Kev Ncaj Ncees Kev Noj Qab Haus Huv: Qhov no yog ib qho kev ntsuas kev noj qab haus huv, siv qhov ntsuas Kev Saib Xyuas Me Nyuam thiab Cov Hluas. Cov qhab nia yuav raug muab tsub yog tias tus nqi mus saib xyuas menyuam tau zoo raug txhim kho rau txhua haiv neeg / haiv neeg.

Kev ntsuas nyiaj laus:

Kev Ntsuas Lub Cev Qhov Ntsuas (BMI): Cov Me Nyuam & Cov Hluas
Kev txhaj tshuaj: Cov neeg laus

Cov Kev Tshawb Fawb Tshiab:

Kev Mus Saib Me Nyuam Zoo rau Hnub Nyoog 15 Lub Hlis - 30 Lub Hlis

2023 Summary of Changes

Tshiab Programmatic Measures:

Adverse Childhood Events (ACEs) Kev tshuaj ntsuam xyuas hauv menyuam yaus thiab cov tub ntxhais hluas tau raug hloov los ntawm kev tshawb nrhiav mus rau qhov kev ntsuas.
Kev Ncaj Ncees Kev Noj Qab Haus Huv yog ib qeb kev ntsuas tshiab, hloov cov phiaj xwm kev noj qab haus huv tsis sib xws ntawm kev tshawb nrhiav kev ntsuas.

Kev ntsuas kev hloov:

Cov ntsiab lus los ntawm Kev Siv Dej Haus Tsis Zoo rau Cov Hluas thiab Cov Neeg Laus tau raug xa rov qab mus rau Cov Txheej Txheem Tsis Zoo Me Nyuam Yaus (ACEs) Kev Tshuaj Ntsuam Xyuas hauv Me Nyuam thiab Cov Hluas.
Cov ntsiab lus los ntawm Ambulatory Care Sensitive Admissions (ACSA), Kev Tiv Thaiv Thaum Muaj Xwm Ceev, Kev Soj Ntsuam Kev Noj Qab Haus Huv (IHA), thiab Kev Ntsuas Zoo tau raug xa rov qab rau kev ntsuas kev noj qab haus huv.

Kev ntsuas tshiab:

Kev kuaj mob qog nqaij hlav hauv plab.

Kev Ntsuas Tus Nqi Tshiab-Rau-Service (FFS):

Adverse Childhood Experiences (ACEs) Kev cob qhia thiab kev lees paub.

Kev ntsuas nyiaj laus:

Kev siv dej cawv tsis zoo rau cov hluas thiab cov neeg laus.
Asthma Medication Ratio.
90-Hnub xa mus ua tiav.
Tuberculosis (TB) Risk Assessment.

Programmatic

Kev ntsuas kev sib koom tes saib xyuas - Kev ntsuas nkag
Ntsuas	Summary Definition	Kev Tsim Nyog Tswvcuab	Cov peev txheej	Cov ntsiab lus tau: 21.5
Kev Tsis Pom Zoo Me Nyuam Yaus (ACEs) Kev tshuaj ntsuam xyuas hauv menyuam yaus thiab cov tub ntxhais hluas *	Qhov feem pua ntawm cov tswv cuab muaj hnub nyoog 1-20 xyoo uas raug tshuaj xyuas rau Adverse Childhood Experiences (ACEs) txhua xyoo siv cov cuab yeej tshuaj ntsuam xyuas.	≥5 Cov Neeg Tsim Nyog Txuas Txuas	Adverse Childhood Experiences (ACEs) hauv Cov Menyuam Yaus thiab Cov Hluas Cov Lus Qhia Kev tshuaj ntsuam cov lis dej num: G9919 - Kev tshuaj xyuas ua tau - cov txiaj ntsig zoo thiab kev pab ntawm cov lus pom zoo muab G9920 - Kev tshuaj xyuas ua tau - cov txiaj ntsig tsis zoo	3
Kev siv Dental Fluoride Varnish	Qhov feem pua ntawm cov tswv cuab muaj hnub nyoog 6 lub hlis txog 5 xyoos (txog lossis ua ntej lawv lub hnub yug 6 xyoos) uas tau txais tsawg kawg ib daim ntawv thov tshuaj fluoride los ntawm cov neeg ua haujlwm ntawm PCP lub chaw ua haujlwm hauv lub xyoo ntsuas.	≥5 Cov Neeg Tsim Nyog Txuas Txuas	Daim Ntawv Thov Kev Kho Hniav Fluoride Varnish Tip Sheet Fluoride Application Code: TIAB SA 99188	2
Kev tshuaj ntsuam kev loj hlob hauv thawj 3 xyoos	Qhov feem pua ntawm cov tswv cuab muaj hnub nyoog 1-3 xyoos tau tshuaj xyuas qhov kev pheej hmoo ntawm kev loj hlob, kev coj tus cwj pwm, thiab kev sib raug zoo qeeb uas siv cov cuab yeej tshuaj ntsuam xyuas tus qauv hauv 12 lub hlis dhau los lossis thawj hnub yug thib ob, lossis thib peb.	≥5 Cov Neeg Tsim Nyog Txuas Txuas	Kev tshuaj ntsuam xyuas kev loj hlob hauv thawj 3 Xyoo Daim Ntawv Qhia Kev ntsuam xyuas kev loj hlob Code: 96110	2
Kev teem caij noj qab haus huv thawj zaug	Cov tswv cuab tshiab uas tau txais kev teem caij noj qab haus huv tag nrho hauv 120 hnub ntawm kev tso npe nrog Alliance.	≥5 Cov Tswvcuab Txuas Txuas txuas ntxiv mus rau npe hauv 120 hnub tom qab tso npe (4 lub hlis)	DHCS MMCD Txoj Cai Tsab Ntawv 22-030 Rau ib daim ntawv teev tag nrho ntawm cov lis dej num saib IHA Daim Ntawv Qhia.	4
Kev saib xyuas tom qab tso tawm **	Cov tswv cuab uas tau txais kev mus ntsib tom qab tso tawm tsis pub dhau 14 hnub tom qab tso tawm hauv tsev kho mob. Qhov kev ntsuas no tsuas yog cuam tshuam rau kev tshem tawm hauv tsev kho mob hnyav xwb. Kev mus ntsib chav xwm txheej ceev tsis tsim nyog.	≥5 Cov Neeg Tsim Nyog Txuas Txuas	Xov Tooj: 99202-99215, 99241-99245, 99341- 99350, 99381-99385, 99391-99395, 99429	10.5
Kev ntsuas kev saib xyuas – Kev ntsuas hauv tsev kho mob thiab tus neeg mob sab nraud
Ntsuas	Summary Definition	Kev Tsim Nyog Tswvcuab	Cov peev txheej	Cov ntsiab lus tau: 25.5
Ambulatory Care Sensitive Admissions	Tus naj npawb ntawm kev saib xyuas neeg mob rhiab nkag (raws li Plan-identified AHRQ specifications) rau 100 Cov Tswv Cuab Tsim Nyog hauv ib xyoos.	≥100 Cov Neeg Tsim Nyog Tsim Nyog Txuas Cov Tswvcuab	Ambulatory Care Sensitive Diagnosis Rau ib daim ntawv teev tag nrho ntawm cov lis dej num saib CBI Technical Specifications	7
Plan All-Cause Readmission**	Tus naj npawb ntawm cov tswvcuab hnub nyoog 18 xyoo thiab laus dua nrog tus neeg mob hnyav thiab kev soj ntsuam nyob hauv lub xyoo ntsuas uas tau ua raws li kev npaj tsis tau npaj rau kev kuaj mob hauv 30 hnub.	≥100 Cov Neeg Tsim Nyog Tsim Nyog Txuas Cov Tswvcuab	Daim Ntawv Qhia Tag Nrho-Cause Readmission Tip Sheet Rau ib daim ntawv teev tag nrho ntawm cov lis dej num saib CBI Technical Specifications	10.5
Kev Tiv Thaiv Thaum Muaj Xwm Ceev	Tus nqi ntawm kev tiv thaiv ED thiab mus ntsib sai rau 1,000 tus tswvcuab hauv ib xyoos. Kev mus ntsib ceev suav yog ib nrab ntawm tus nqi raws li ED mus ntsib	≥100 Cov Neeg Tsim Nyog Tsim Nyog Txuas Cov Tswvcuab	Alliance Case Management thiab Care Coordination Programs Daim Ntawv Qhia Txog Kev Tiv Thaiv Thaum Muaj Xwm Ceev Daim Ntawv Qhia Txog Kev Tiv Thaiv Thaum Muaj Xwm Ceev	8
Kev ntsuas kev saib xyuas zoo
Ntsuas	Summary Definition	Kev Tsim Nyog Tswvcuab	Cov peev txheej	Cov ntsiab lus tau: 38
Kev kuaj mob cancer mis	Qhov feem pua ntawm cov poj niam hnub nyoog 50 - 74 xyoo uas tau kuaj mob qog noj ntshav rau lub mis rau lossis thaum Lub Kaum Hli 1 ob xyoos ua ntej Lub Sijhawm Ntsuas thiab qhov kawg ntawm Lub Sijhawm Ntsuas.	≥30 Cov Neeg Tsim Nyog Tsim Nyog Txuas Cov Tswvcuab	Daim ntawv qhia txog kev kuaj mob cancer mis Kev kuaj mob qog noj ntshav mis: 77061-77067 Rau ib daim ntawv teev tag nrho ntawm cov lis dej num saib CBI Technical Specifications	Ntau yam
Cervical Cancer Screening	Cov poj niam hnub nyoog 21-64 xyoo uas tau kuaj mob khees xaws ncauj tsev menyuam siv ob yam hauv qab no: 21-64 xyoo uas muaj lub ncauj tsev menyuam cytology ua nyob rau hauv 3 xyoo dhau los, pib thaum muaj hnub nyoog 21; los yog 30-64 xyoo uas muaj kev pheej hmoo siab ntawm lub ncauj tsev menyuam papillomavirus (hrHPV) kuaj tau ua nyob rau hauv 5 xyoo dhau los; los yog 30-64 xyoo uas muaj cervical cytology / HPV co-test ua nyob rau hauv 5 xyoo dhau los	≥30 Cov Neeg Tsim Nyog Tsim Nyog Txuas Cov Tswvcuab	Cervical Cancer Screening Tip Sheet Cervical Cancer Screening Codes: Q0091 - Kev siv cov cai no yuav ua kom muaj kev ua raws li tau txais, npaj thiab xa cov tshuaj smear ntawm ncauj tsev menyuam mus rau chav kuaj es tsis yog cia siab rau lub chaw kuaj mob kom xa daim ntawv thov. Txhawm rau tshem tawm cov tswv cuab los ntawm kev ntsuas: Z90.710 - tsis muaj lub ncauj tsev menyuam thiab lub tsev menyuam Z90.712 - tsis muaj lub ncauj tsev menyuam nrog lub tsev menyuam Q51.5 - agenesis thiab aplasia ntawm ncauj tsev menyuam (Tuaj yeem siv rau tus txiv neej-rau-poj niam hloov pauv) Rau ib daim ntawv teev tag nrho ntawm cov lis dej num saib CBI Technical Specifications	Ntau yam
Kev Saib Xyuas Menyuam Yaus thiab Cov Hluas (3-21 xyoos)*	Qhov feem pua ntawm cov tswv cuab hnub nyoog 3–21 xyoo uas muaj tsawg kawg yog ib qho kev saib xyuas zoo nrog PCP lossis tus kws kho mob OB/GYN thaum lub xyoo ntsuas.	≥30 Cov Neeg Tsim Nyog Tsim Nyog Txuas Cov Tswvcuab	Phau Ntawv Qhia Txog Kev Saib Xyuas Menyuam Yaus thiab Cov Hluas Zoo-Koom Haum Codes: 99382-99385, 99392-99395, Z00.00-Z00.01, Z00.121-Z00.129, Z00.2-Z02.3, Z02.5, Z02.825, Z76.1, Z76.1 .2	Ntau yam
Kev Ntsuam Xyuas Kev Nyuaj Siab rau Cov Hluas thiab Cov Neeg Laus	Qhov feem pua ntawm cov tswvcuab hnub nyoog 12 xyoos thiab laus dua uas tau kuaj mob rau kev nyuaj siab siv lub hnub nyoog tsim nyog tus qauv, ua thaum Lub Ib Hlis 1 thiab Kaum Ob Hlis 1 ntawm lub sijhawm ntsuas.	≥30 Cov Neeg Tsim Nyog Tsim Nyog Txuas Cov Tswvcuab	Daim Ntawv Qhia Txog Kev Nyuaj Siab rau Cov Hluas thiab Cov Neeg Laus LOINC Cov Cai: 89208-3, 89209-1, 89205-9, 71354-5, 90853-3, 48545-8, 48544-1, 55758-7, 44261-6, 89204-6, 89204-2, , 71777-7, ib	Ntau yam
Mob ntshav qab zib HbA1c Tsis Zoo Tswj> 9.0%	Cov tswv cuab hnub nyoog 18-75 uas tau kuaj HbA1c hauv 12 lub hlis dhau los, thiab qhov kev xeem HbA1c tsis ntev los no tau tshwm sim los ntawm> 9.0%. Cov tswvcuab uas tsis muaj qhov kuaj tau xa tuaj yuav raug suav tias tsis ua raws li qhov ntsuas no. (Qhov no yog qhov ntsuas rov qab: tus nqi qis dua yog qhov zoo dua)	≥30 Cov Neeg Tsim Nyog Tsim Nyog Txuas Cov Tswvcuab	Ntshav Qab Zib HbA1c Tswj Tsis Zoo> 9% Daim Ntawv Qhia Kev Kawm Txuj Ci Kev Noj Qab Haus Huv thiab Kev Tswj Xyuas Kab Mob HbA1c Test Codes: 83036, 83037 HbA1c Cov txiaj ntsig: 3044F - 3046F, 3051F, 3052F	Ntau yam
Kev txhaj tshuaj: Cov tub ntxhais hluas	Cov tub ntxhais hluas muaj hnub nyoog 13 xyoos uas tau txais cov tshuaj tiv thaiv kab mob hauv qab no thaum lub hnub nyoog 13 xyoos: 1 koob tshuaj meningococcal conjugate 1 koob tshuaj tetanus, diphtheria, thiab pertussis (Tdap) 2 koob tshuaj human papillomavirus (HPV)	≥30 Cov Neeg Tsim Nyog Tsim Nyog Txuas Cov Tswvcuab	Kev txhaj tshuaj tiv thaiv: Daim Ntawv Qhia Cov Hluas Immunization Codes: Meningococcal - 90619, 90733, 90734, 428301000124106 (Anaphylaxis vim yog tshuaj tiv thaiv MCV) Tdap – 90715, 428281000124107, 428291000124105 (Anaphylaxis due to Tdap Vaccine), 192710009, 192711008, 192712001 (Encephal Vaccine to Tdap) HPV – 90649, 90650, 90651, 428241000124101 (Anaphylaxis vim yog txhaj tshuaj tiv thaiv HPV)	Ntau yam
Kev txhaj tshuaj: Me nyuam (Cov lus qhia 10)	Cov menyuam yaus hnub nyoog qis dua 2 xyoos uas tau txais tag nrho cov tshuaj tiv thaiv hauv qab no los ntawm hnub yug lossis hnub yug thib 2: 4 kab mob diphtheria, tetanus, acellular pertussis (DTaP) lossis keeb kwm ntawm anaphylaxis lossis encephalitis vim yog txhaj tshuaj tiv thaiv DTap; 3 txhaj tshuaj tiv thaiv kab mob polio inactivated (IPV); 1 mob qhua pias, mumps thiab rubella (MMR) lossis keeb kwm ntawm qhua pias, mumps thiab rubella. 3 haemophilus influenza type B (HiB) lossis anaphylaxis vim yog txhaj tshuaj tiv thaiv Hib; 3 kab mob siab B (HepB) lossis anaphylaxis vim yog txhaj tshuaj tiv thaiv kab mob siab B; 1 varicella (VZV) keeb kwm ntawm varicella zoster (piv txwv li qaib pox). 4 pneumococcal conjugate (PCV) 2 lossis 3 rotavirus (RV), lossis anaphylaxis vim yog cov tshuaj tiv thaiv kab mob rotavirus; 1 kab mob siab A (HepA), lossis keeb kwm ntawm kab mob siab A; 2 mob npaws (flu)	≥30 Cov Neeg Tsim Nyog Tsim Nyog Txuas Cov Tswvcuab	Kev txhaj tshuaj: Cov Me Nyuam (Combo 10) Daim Ntawv Qhia Rau ib daim ntawv teev tag nrho ntawm cov lis dej num saib CBI Technical Specifications	Ntau yam
Kev tshuaj ntsuam txhuas hauv cov menyuam yaus	Qhov feem pua ntawm cov menyuam yaus hnub nyoog 2 xyoos uas muaj ib lossis ntau dua capillary lossis venous lead ntshav kuaj rau cov tshuaj lom tshuaj txhuas los ntawm lawv lub hnub yug thib ob	≥30 Cov Neeg Tsim Nyog Tsim Nyog Txuas Cov Tswvcuab	Kev tshuaj ntsuam txhuas hauv cov ntawv qhia me nyuam Lead Screening Codes: 83655 Rau ib daim ntawv teev tag nrho ntawm cov lis dej num saib CBI Tech Specs.	Ntau yam
Kev Mus Saib Me Nyuam Zoo hauv Thawj 15 Lub Hlis	Cov tswv cuab hnub nyoog 15 lub hlis uas muaj 6 lossis ntau dua kev mus ntsib tus menyuam zoo nrog PCP thaum thawj 15 lub hlis ntawm lub neej.	≥30 Cov Neeg Tsim Nyog Tsim Nyog Txuas Cov Tswvcuab	Zoo-Me Nyuam Mus Saib Thawj 15 Lub Hlis Daim Ntawv Qhia Well-Child Visit Codes: 99381, 99382, 99391, 99392, 99461, Z00.110-Z00.129, Z00.2 Z02.5, Z76.1, Z76.2	Ntau yam
Kev Ntsuas Lub Hom Phiaj
Ntsuas	Summary Definition	Kev Tsim Nyog Tswvcuab	Cov peev txheej	Cov ntsiab lus ua tau
Kev ntsuas kev ua tau zoo	Cov kws kho mob tuaj yeem tau txais cov qhab nia Txhim Kho Kev Ua Haujlwm rau txhua qhov kev ntsuas lawv tsim nyog los ntawm ob qho: Ua raws li Lub Hom Phiaj Npaj, lossis Kev Ua tiav 5% kev txhim kho piv rau xyoo dhau los.	Ntsuas cov kev cai tsim nyog rau cov tswv cuab tshwj xeeb	Programmatic Measure Benchmarks & Performance Improvement	10
Kev ntsuas ntsuas
Ntsuas	Summary Definition	Kev Tsim Nyog Tswvcuab	Cov peev txheej	Cov ntsiab lus ua tau
Kev kuaj mob chlamydia hauv cov poj niam	Cov poj niam hnub nyoog 16 txog 24 xyoo uas raug txheeb xyuas tias yog kev sib deev thiab leej twg muaj tsawg kawg yog ib qho kev kuaj mob chlamydia thaum lub xyoo ntsuas	≥30 Cov Neeg Tsim Nyog Tsim Nyog Txuas Cov Tswvcuab	Kev kuaj mob chlamydia hauv Cov Poj Niam Tip Sheet Kev kuaj kab mob chlamydia: 87110, 87270, 87320, 87490-87492, 87810	N/A
Tswj ntshav siab	Cov tswvcuab hnub nyoog 18–85 xyoo uas tau kuaj pom tias muaj ntshav siab (HTN) thiab nws cov ntshav siab tau tswj tau zoo (140/90 mm Hg) hauv 12 lub hlis dhau los. Kev nyeem ntawv BP yuav tsum tshwm sim rau lossis tom qab hnub kuaj HTN thib ob.	≥30 Cov Neeg Tsim Nyog Tsim Nyog Txuas Cov Tswvcuab	Tswj Cov Ntshav Qab Zib Cov Lus Qhia Tswj Cov Ntshav Siab Codes: 3074F, 3075F, 3077F, 3078F, 3079F, 3080F	N/A
Kev kuaj mob qog nqaij hlav hauv plab	Qhov feem pua ntawm cov tswv cuab 45-75 xyoo uas muaj kev tshuaj xyuas tsim nyog rau kev mob qog nqaij hlav hauv plab. Rau cov tswv cuab 46-75 xyoo siv ib qho ntawm cov hauv qab no: Fecal occult ntshav kuaj hauv xyoo tas los. Sigmoidoscopy yooj yim hauv 5 xyoo dhau los. Colonoscopy hauv 10 xyoo dhau los. CT colonography hauv 5 xyoo dhau los. Cov quav DNA (sDNA) nrog FIT kuaj hauv 3 xyoos dhau los.	≥30 Cov Neeg Tsim Nyog Tsim Nyog Txuas Cov Tswvcuab	Daim ntawv qhia txog kev kuaj mob khees xaws mis Fecal occult blood test CPT lis dej num: 82270, 82274 Flexible sigmoidoscopy CPT lis dej num: 45330-45350 Colonoscopy codes: PIB: 44388-44394, 44397, 44401-44408, 45355, 45378-45393, 45398 ICD-9: 45.22-45.23, 45.25, 45.42-45.43 CT colonography CPT lis dej num: 74261-74263 Cov quav DNA (sDNA) nrog FIT CPT code: 81528	N/A
Zoo-Me nyuam mus ntsib rau hnub nyoog 15-30 Lub Hlis Lub Neej	Qhov feem pua ntawm cov tswv cuab hnub nyoog 30 lub hlis uas muaj 2 lossis ntau dua kev mus ntsib tus menyuam zoo nrog PCP ntawm tus menyuam hnub yug 15 hli ntxiv rau ib hnub thiab hnub yug 30 hli.	≥30 Cov Neeg Tsim Nyog Tsim Nyog Txuas Cov Tswvcuab	Phau Ntawv Qhia Txog Kev Noj Qab Haus Huv Me Me rau Hnub nyoog 15-30 Lub Hlis Well-Child Visit Codes: 99382, 99392, 99461, Z00.121, Z00.129, Z00.2, Z76.1, Z76.2, Z02.5	N/A
Health Equity Measure
Ntsuas	Summary Definition	Kev Tsim Nyog Tswvcuab	Cov peev txheej	Cov ntsiab lus ua tau
Health Equity*	Qhov no yog ib qho kev ntsuas kev noj qab haus huv, siv Kev Ntsuas Me Nyuam thiab Kev Saib Xyuas Neeg Hluas. Cov ntsiab lus yuav tau txais rau 5 – 10% kev txhim kho rau txhua haiv neeg.	30	CBI Technical Specifications Phau Ntawv Qhia Txog Kev Saib Xyuas Menyuam Yaus thiab Cov Hluas Zoo-Koom Haum Codes: 99382-99385, 99392-99395, Z00.00-Z00.01, Z00.121-Z00.129, Z01.411, Z01.419, Z00.2, Z00.3, Z02.5 .1, Z76.2	5

Nqi-rau-Service

Xyaum Tswj Kev Ntsuas
Ntsuas	Summary Definition	Cov peev txheej
Adverse Childhood Experiences (ACEs) Kev cob qhia thiab kev lees paub	Kev npaj yuav them rau cov kws kho mob, uas suav nrog cov kws kho mob nruab nrab, txhawm rau ua kom tiav ACEs kev cob qhia thiab ua pov thawj. Txoj kev npaj yuav them rau txhua pawg CBI $200 uas tus kws kho mob ua raws.	$200 them ib zaug Kev them nyiaj ib zaug tom qab tau txais lub Xeev ceeb toom ntawm kev cob qhia thiab kev lees paub tiav. Kev them nyiaj tsis rov tshwm sim txhua xyoo lossis peb lub hlis twg. CBI Technical Specifications
Cwj pwm kev noj qab haus huv kev koom ua ke	Txoj kev npaj yuav tsum them $1,000 ib zaug them rau cov neeg muab kev pabcuam rau kev ua tiav ntawm NCQA Distinction in Behavioral Health Integration. Kev them nyiaj yog ua ib zaug tom qab kev sib txawv tau txais los ntawm Alliance. Kev them nyiaj tsis rov tshwm sim txhua xyoo lossis peb lub hlis twg.	CBI Technical Specifications
Cognitive Health Assessment Training and Attestation	Kev npaj yuav them rau cov kws kho mob, uas suav nrog cov kws kho mob nruab nrab, txhawm rau ua tiav DHCS kev paub txog kev ntsuas kev noj qab haus huv thiab kev lees paub. Txoj kev npaj yuav them rau txhua pawg CBI $200 uas tus kws kho mob ua raws.	$200 them ib zaug Kev them nyiaj ib zaug tom qab tau txais lub Xeev ceeb toom ntawm kev cob qhia thiab kev lees paub tiav. Kev them nyiaj tsis rov tshwm sim txhua xyoo lossis peb lub hlis twg. CBI Technical Specifications
Diagnostic Accuracy thiab Completeness Training	Txoj kev npaj yuav them rau cov chaw muab kev pab ua kom tiav CMS Diagnostic Accuracy thiab Completeness Training.	$200 them ib zaug Kev them nyiaj ib zaug tom qab tau txais daim ntawv pov thawj ceeb toom ntawm kev kawm tiav.
Kev Txhim Kho Kev Ua Haujlwm Zoo	Kev npaj yuav them rau cov chaw muab kev pabcuam $1000 rau txhua qhov chaw ua haujlwm uas ua tiav Alliance muab Kev Txhim Kho Kev Ua Haujlwm Zoo. Tsuas yog cov chaw ua haujlwm nrog cov kev ntsuas uas qis dua qhov ua tau zoo tsawg kawg nkaus, ntsuas ntawm 50 feem pua rau xyoo 2023 cov nyiaj them poob haujlwm tau tsim nyog tau txais kev them nyiaj rau kev ua tiav Cov Kev Txhim Kho Kev Ua Haujlwm Zoo.	$1,000 ib zaug them nyiaj tom qab ceeb toom ntawm qhov project tiav.
Patient Centered Medical Home (PCMH) Kev lees paub	Kev npaj yuav tsum them ib zaug them nyiaj ntawm $2,500 rau cov neeg muab kev pabcuam rau kev ua tiav ntawm NCQA kev lees paub lossis Lub Koom Haum Koom Tes (TJC) ntawv pov thawj. Ib daim qauv ntawm kev lees paub / ntawv pov thawj yuav tsum tau txais los ntawm Alliance. Kev them nyiaj tsis rov tshwm sim txhua xyoo lossis peb lub hlis twg.	Rau cov neeg muab kev pabcuam xa lawv thawj daim ntawv thov rau NCQA PCMH Recognition, siv Alliance luv nqi code CCAAHA rau txuag 20% ntawm koj tus nqi pib ua ntawv thov. CBI Technical Specifications
Social Determinants of Health (SDOH) ICD-10 Z Code Submission	Kev npaj yuav them cov tsev kho mob uas xa DHCS Social Determinants of Health (SDOH) qhov tseem ceeb ICD-10 Z-codes.	$250 peb lub hlis twg cov nyiaj them rau cov ntaub ntawv xa nrog qhov tseem ceeb SDOH Z-codes, nrog $1,000 qhov nyiaj them siab tshaj plaws.

CBI ncua sij hawm

Health and Wellness Rewards Program

Cov lus nug?
Hu rau koj Tus Neeg Saib Xyuas Kev Sib Raug Zoo lossis hu rau Chaw Pabcuam ntawm (800) 700-3874 ext. 5504 ib

Tswj Kev Kho Mob

Care-Based Incentive (CBI) Summary

Tau txais kev pab

Kev Pabcuam Tswvcuab

Lub Alliance

Cov cuab yeej siv tau yooj yim