Reorganization of Questions in eValu8 2014 RFI-Input and Output
Background
Plan Sponsors provided feedback over the past few years that the organization of the summary of plan
responses to the eValue8 RFI could be improved to more closely align with how they thought about plan
activities. A reorganized format proposed by a Plan Sponsor was discussed with Coalition leaders who
supported this change. Sample reports were produced and provided to gather feedback from Plan Sponsors
and a subset of Plan respondents.
The change in organization of the questions was discussed at the September 25th eValue8 annual meeting
with the Plan and Coalition attendees (in person and on the phone) to gather feedback on the new organization
and timing of implementation of the output (Summary report) and input (RFI)
All attendees voted to implement the change in both the RFI and the Summary Report for eValue8 2014. Plan
respondents told NBCH that this reorganized format more closely aligned with how they produce reports.
What does this mean
When respondents receive the email invitation to participate in eValue8 2014, they will access Proposal Tech
to begin the response process. One key difference is the RFI will now consist of 8 Modules instead of 7
modules. Many of the Module and section titles will be different; however the questions are not different,
although they may be relocated. Please review the module and section information below as well as the
summary of changes.
Resources to support this change
As in previous releases of eValue8, a mapping document will be provided that will map the question number in
eValue8 2014 to eValue8 2013 and eValue8 2012.
The “default source” feature in ProposalTech will also be available so respondent can see scored response to
the question from prior year and either change their response or confirm the prior response.
Current (eValue8 2013 and prior) and New (eValue8 2014) Components
Current Organization of Modules/Sections/Questions
Plan Profile
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Contact & Organization Information
Enrollment & Scope of RFI Response
Services & Compliance Review
Provider Management
Purchaser Support
Health Information Technology
Racial, Cultural & Language Competency
Innovations
Consumer Engagement
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Alignment of Plan Design
Practitioner Information & Connectivity
Hospital Choice Support
Shared Decision Making & Treatment Option Support
Electronic Personal Health Record
Claims Management & Price Transparency
Performance Measurement
New Organization of Modules/Sections/Questions
Business Profile
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Contact & Organization Information
Market Position
Accreditation & CAHPS Performance
Business Practices & Results
Collaborative Practices
Innovations
Other Information
Physician & Hospital Management & Measurement
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Management & Contracting
Physician Support & HIT
Information to Physicians to Help Steer Members
Physician Management and Support to Help Members Stay Healthy
Physician Management and Support to Help Members Manage
Chronic Conditions
Scope of Physician Measurement for Transparency and Rewards
Physician Payment Programs for Value Achievement (Quality and/or
Efficiency)
Plan Policies on Healthcare Acquired Conditions and Never Events
Hospital Payment Programs for Value Achievement
Plan Steerage of Members to Centers of Excellence and Higher
Value Physicians and Hospitals
Hospital Management Performance
Provider Measurement
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Community Collaboration for Provider Measurement
Physician Support & HIT
Physician Performance Measurement & Reporting
Physician/Practice Site and Medical Group/IPA Value
Differentiation and Payment Rewards
Hospital Services Performance Measurement and Reporting
Efficiency and Overuse
Hospital Value Differentiation and Payment Rewards
Centers of Excellence or High Performance Hospital Network
Pharmaceutical Management
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Program Organization
Efficiency & Appropriateness: Generic & Appropriate Drug Use
Specialty Pharmaceuticals
Quality and Safety: Outpatient Prescribing
Prevention & Health Promotion
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Health Promotion Programs and Worksite Wellness
Health Assessments (HA)
Cancer Screening Programs & Results
Immunization Programs
Prevention & Treatment of Tobacco Use
Obesity
Obstetrics and Maternity and Child
Chronic Disease Management
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Program Scope & Coordination
Member Identification & Support
Practitioner Support
Performance Measurement: CAD
Performance Measurement: Diabetes
Performance Measurement: Other Conditions
Behavioral Health Management
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Plan Organization
Member Screening & Support
Practitioner Support
Performance Measurement
Helping Members Stay Healthy
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Alignment of Plan Design
Health Assessments (HA)
Cancer Screening Programs & Results
Immunization Programs
Health Promotion Programs and Worksite Wellness
Prevention & Treatment of Tobacco Use
Obesity
CAHPS Performance
Helping Members Become Good Consumers
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Addressing language and health literacy needs
Alignment of Benefit Design and Incentives
Electronic Personal Health Record
Help Finding the Right Doctor
Hospital Choice Support
Shared Decision Making & Treatment Option Support
Price Transparency - Helping Members Pay the Right Cost
HEDIS & CAHPS Performance
Helping Members Manage Acute/Episodic Conditions
 Alignment of Plan Design
 Obstetrics and Maternity and Child
 Bariatric Surgery
 End of Life and Hospice Care
Helping Members Manage Chronic Conditions
 Program Availability (Standard or Buy-Up, Stand) and Co-ordination
 Member Identification & Support for CAD & Diabetes
 Performance Measurement: CAD & Diabetes
 Plan Organization for Behavioral Health Management
 Member Screening & Support in Behavioral Health
 Performance Measurement: Behavioral Health
 Performance Measurement: Other Conditions
Pharmaceutical Management
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Value-Based Formulary
Efficiency & Appropriateness: Generic & Appropriate Drug Use
Specialty Pharmaceuticals
Quality and Safety: Outpatient Prescribing
Client Support, Data Analyses and Reporting
 Beneficiary Communication and Benefit Design
 Data Analyses and Reporting
New Purchaser Report and Plan RFI – “Summary of Changes”
What Moved In
Module
What Moved out
CAHPS Rating of Health Plan & Health Care from Consumer
Community Collaboration from Provider
Prometheus PACs from Provider
Business Profile
Hospital Accreditation & Treatment of Claims if no contract
with Specialist
Meaningful Use and eRxing
All but 2 questions in Cultural Disparities to “Good
Consumer”
Beneficiary communication and outreach support and
Purchaser Reports to Client Support
Hospital Accreditation & Treatment of Claims if no contract
with Specialist from Profile
Meaningful Use and eRxing from Profile
Support and services-treatment decision support, Choosing
Wisely from Consumer
Monitor screening for tobacco use from Prevention
Practitioner Education Support (tobacco, obesity, PCMH,
diabetes, CAD, depression and alcohol) including
reimbursement for SBIRT
Monitoring use of screening tools for alcohol and
depression and appropriate prescribing of anti-depressants
Engaging ERs and trauma centers on alcohol screening and
interventions
Benefit Design for Wellness & Prevention from Consumer
CAHPS rating for member communication from Consumer
All but 2 questions in Cultural Disparities from Profile
Public reports of physician and hospital quality from
Provider
HEDIS Overuse Procedures from Provider
Physician & Hospital Management &
Measurement
Community Collaboration to Business Profile
Prometheus PACs from Provider to Business Profile
Helping Members Stay Healthy
Bariatric surgery to “Episodic care”
Maternity & Obstetrics to “Episodic care”
Alignment of Incentives through plan design to Client
Support
Benefit Design for Wellness & Prevention to “Stay Healthy
Benefit design for acute care to” Episodic care” and for
Chronic Disease to “Chronic Conditions”
End of Life Care Program and Hospice Services
to “Episodic care”
Benefit Design for Acute Care from Consumer
End of Life Care Program from Consumer
Hospice Services from Consumer
Bariatric surgery from Prevention & Wellness
Maternity & Obstetrics from Prevention & Wellness
(includes payment reform t o reduce elective deliveries)
Benefit design for Chronic Disease from Consumer
Entire BH module except to Provider Support
Helping Members Manage
Acute/Episodic Conditions
None
Helping Members Manage Chronic
Conditions
None
Beneficiary communication and outreach support from
Profile
Purchaser Reports from Profile
Alignment of Incentives through plan design from Consumer
Pharmaceutical Management
Client Support, Data Analyses &
Reporting
Provider Support for CAD and Diabetes to Physician &
Hospital
Non-HEDIS measures for CAD, Diabetes and Depression DM
programs (ROI, Absenteeism) to Client Support
None
None
Helping Members Become Good
Consumers