1.7 Million beneficiaries in 2010 (includes YHP patients in IHC); every beneficiary required to select a primary care cliniciana |
Monthly care management fees: $2 for children, $3 for adults, $4 for disabled or elderly beneficiariesa |
Pediatric claims paid within 30 days; adult claims paid within 60 days |
Quarterly academic detailing about the administration of the program and clinical care of the patient population for primary care clinicians |
Multiple online tools such as registries and report cards to assist clinicians with population-based managementb |
IHC providers required to make preventive care available within 5 weeks of request (or 2 weeks for infants younger than 6 months), urgent care appointments within 24 hours, appointments for non-serious complaints within 3 weeks, and follow-up visits within 7 days of discharge from an emergency department or hospitala |
Practices required to provide and coordinate maternal and child health servicesa |
Practices required to institute an action plan for enrollees with chronic diseasesa |
Quality-based bonus paymentsa |