Payment Transformation Performance Measure Reporting Guidelines (updated 03/02/2018)
Total Cost of Care (updated 01/04/2017)
The Payment Transformation Program Guide is available on HHIN. Click here to log in.
If you disagree with an aspect of the Payment Transformation program and wish to request a review, please use the following form. Please fill out the form in its entirety and include any supporting documentation. Email the form and supporting documentation to PSinquiries@hmsa.com.
Payment Transformation Review Request Form (Effective 10/1/2018)
*NOTE: Do not use this form if you are requesting to exclude a member from the denominator of a performance measure. Those requests should be submitted electronically through Coreo. Please see the Payment Transformation Program Guide for more details.
Click on the links below for information designed to help providers and office staff engage with their patients.
|Rev#:||Date:||Nature of Change:|
|1.0||04/07/2016||Updated page with links to various Payment Transformation 2016 Pilot Value Sets.|
|1.1||05/18/2016||Added a link to the Patient Attribution Training Webinar 5/6/16.|
|1.2||07/06/2016||Added 2 links under a new section called "Request for Reconsideration".|
|1.3||08/23/2016||Added a link to the Payment Transformation Event page.|
|1.4||09/19/2016||Updated the code set lists. Added 4 new ones: ED Utilization, Hospitalization for Preventable Chronic ACSC, Controlling Blood Pressure, CSHCN Screener.|
|1.5||09/21/2016||Added new link: TCOC- Behavioral Health Exclusion Codes.|
|1.6||10/27/2016||Added new link: Payment Transformation Annual Provider Survey.|
|1.7||12/08/2016||Added new link: EPSDT under a new Code Value Set 2017 section.|
|1.8||12/31/2016||Added the 2017 Payment Transformation PCP Tool Kit section.|
|1.9||01/06/2017||Uploaded revised TCOC Summary and added note next to Total Cost of Care link: "Updated. Version 01/04/17."|
|1.10||01/10/2017||DELETED: Coding Summaries section including link for “Adult measures” and “Pediatrics”.|
|1.11||01/13/2017||Updated the link for the Payment Transformation Performance Measure Reporting Guidelines.|
|1.12||01/23/2017||Added links to the Payment Transformation Measure 2017 Value Sets.|
|1.13||02/03/2017||Added a new link to: 2017 Program - Performance Measure Exclusion Request.|
|1.14||02/13/2017||Added a new link to: Closing Care Gaps via Telephone Encounters- Reporting Guidelines.|
|1.15||02/22/2017||Added two new sections PCP PT Training Resources & Payment Transformation for Specialists. Also added a link to the Specialty Payment Transformation Update Mailer.|
|1.16||03/22/2017||Added a new section Payment Transformation Program Guide.|
|1.17||04/10/2017||Updated the Patient Attestation Form section. Added the following forms: Korean, Ilocano, Vietnamese, Chinese|
|1.19||07/26/2017||Updated the video link to Patient Attribution Training 05/06/2016 (Video).|
|1.20||07/26/2017||Updated the link to Closing Care Gaps via Telephone Encounters- Reporting Guidelines with current version (7/21/17)|
|1.21||09/11/2017||Added a link to the Patient Attestation Form - Spanish.|
|1.22||10/19/2017||Updated Payment Transformation Annual Provider Survey due date to December 31, 2017.|
|1.23||12/01/2017||Updated the link to Patient Attribution (updated 11/30/2017).|
|1.24||12/05/2017||Added a new section: 2018 Payment Transformation PO Tool Kit.|
|1.25||12/13/2017||Updated the following links: 2017 Program - Performance and Engagement Measure Scoring and Payment and 2017 Program - Scoring and Payment Total Cost of Care.|
|1.26||12/18/2017||Moved 2016 Full code set to new Archived page. Link has been provided in the Full Codes Sets Archived section (above Request for Reconsideration.)|
|1.26||12/26/2017||Added the 2018 Full Code Set.|
|1.27||12/27/2017||Added a link to the TCOC Behavioral Health Services Exclusions document. Revised header: Full Code Set Archive to Historic Code Sets Archive|
|1.29||12/28/2017||Added the 2018 PT Measure Value Set: 2018 Measure Value Set_Controlling Blood Pressure 2018 Measure Value Set_CSHCN Screener 2018 Measure Value Set_Hospitalization for Preventable Chronic ACSC 2018 Measure Value Set_AvoidableED|
|1.30||02/02/2018||Added the Avoidable ED Visits Improvement Plan Submission Forms section under the 2018 Payment Transformation PO Tool Kit. Added the following links: 2018 Program - Performance and Engagement Measure Scoring and Payment and 2018 Program - Scoring and Payment Total Cost of Care.|
|1.31||03/02/2018||Updated the link: Payment Transformation Performance Measure Reporting Guidelines|
|1.32||03/30/2018||Added box with link to Coreo Resource Library.|
|1.33||04/30/2018||The patient attestation forms (in multiple languages) and the pediatric patient attestation forms were removed.|
|1.34||09/11/2018||Timely Access for New Patients Submission Form was updated.|
|1.35||10/02/2018||Update to the Request for Reconsideration section. Added a link to the new request form, effective 10/1/18.|
|1.36||10/04/2018||Update to the Request for Reconsideration section. Renamed to Requests for Reconsideration and Program Exceptions. Removed 2017 & 2018 links to the Performance Measures and Scoring and Payment Total Cost of Care documents.|
|1.37||10/04/2018||Updated the Payment Transformation Annual Provider Survey link for 2018.|
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