The Baseline Report shows patient data and performance for the 2010 calendar year. It reports your performance and quality dollars that hypothetically could have been earned if the pay-for-quality program had been in effect last year. HMSA will not display patient data for each measure.
The Maximum Quality Pay is calculated by taking the count of all the eligible patients (PPO and HMO) in your patient panel each month, multiplied by $2.00. Based on weight factors that consider the number of patients in a measure and the relative importance of a measure, a percentage of the maximum payment is apportioned to each measure. The report tells you:
- Denominator ("Estimated Measure Panel Size") and Numerator ("Base Year Numerator Count") for each measure, and percentage ("Base Year Rate").
- How that percentage compares against national percentile rankings ("National Percentile Rank").
- The additional number of patients that would have been needed in the numerator for you to have achieved the 90th national percentile.
- The maximum quality dollars per measure is shown in the "Estimated Max Award Amount."
On the detail page for each measure, you'll see the quality payments at each of the percentile rankings – 10th, 25th, 50th, 75th and 90th. This information may be helpful as you plan your work for 2011.