(a) use of the workgroup metrics to measure and reward physician,
clinic and hospital performance;
(b) involvement of multiple payers, including government programs,
multiple providers and multiple communities voluntarily agreeing to
employ the workgroup metrics to reward physician, clinic and hospital
performance for quality improvement;
(c) use of information technology to share patient information among
providers to improve coordination of patient care;
(d) targeted improvement in care coordination through the
participation of multiple stakeholders;
(e) collection, analysis and public reporting on the risk-adjusted
measures, incentives and processes utilized, and outcomes; and
(f) programs to enhance patient self-management through adherence to
treatment plans.
2. In evaluating proposed demonstration projects, the commissioner
shall consider the degree to which a proposed project reflects the
elements listed above including demonstrated commitments on the part of
all practitioners, providers and payors to participate.
3. (a) There shall be no more than five demonstration projects under
this title.
(b) Where any demonstration project involves recipients of Medicaid,
family health plus, or child health plus, those recipients shall not
constitute more than half the individuals covered by the demonstration
project and their health care, measured in the amount of annual
reimbursement, shall not cover more than half of the health care covered
by the demonstration project.
(c) No demonstration project shall limit the scope or terms of
coverage or limit the grounds or procedural rights for appealing a
denial of reimbursement for a health care service, for any consumer,
enrollee, or recipient subject to the demonstration project.
* NB Expired April 1, 2011