2010-06-07_(2).pdf - 19318.8K - BridgeportCT.gov

CIGNA HealthCare Performance Guarantee Agreement
Customer Bridgeport City BOE
Effective Date July 1 2010
Account Number s involved in Performance Guarantee s 3213172
IIr
CIGNA
Table 1 Detailed Measurement Methodology for Disease Management Guarantees Client
Specific
DetailedMeasurement Methodology Appropriate use of Mef rications
Denominator Number ofAsthma Participants
who
1 have no less than ten 10 months of eligibility in the Baseline Period
2 have no less than ten 10 months ofeligibility and program participation history in the Guarantee Period
3 did not voluntarily opt out ofthe Asthma Well Aware Program
4 did not claim to have been falsely identified with Asthma and are not deceased
The Denominator will be calculated by Connecticut General using data in the CIGNA HealthCare
Well Aware Clinical Information System
Numerator The number ofAsthma Participants included in the Denominator whoparticipated
during the Guarantee Period The numerator will be calculated by Connecticut General using the
Employer s Medical Management Claims Set To be included in the numerator the Participant must
1 have no less than ten 10 months of eligibility in the Baseline Period
2 have no less than ten 10 months ofeligibility and program exposure in the Guarantee Period
DetailedMeasurement Methodology LDL
Denominator The numberof CHD and Diabetes Participants who
1 have no less than ten 10 months of eligibility in the Baseline Period
2 have no less than ten 10 months of eligibility and program participation history in the Guarantee Period
3 did not voluntarily opt out of the cardiac Well Aware Program
4 did not claim to have been falsely identified with coronary heartdisease and
5 are not deceased
The Denominator will be calculated by Connecticut General using data in the CIGNA HealthCare
Well Aware Clinical Information System
Numerator The number of CHD and Diabetes Participants included in the Denominator who
participated during the Guarantee Period The numerator will be calculated by Connecticut General
using the Employer s Medical Management Claims Set To be included in the numerator the
Participant must
1 have no less than ten 10 months of eligibility in the Baseline Period
2 have no less than ten 10 months of eligibility and program exposure in the Guarantee Period
Participants aredefined in Exhibit B
OS 28 2010
2010 Performance Guarantee Page 26