The Premium program consists of both quality and cost-efficiency evaluations. Quality is the primary program measurement and is evaluated using national standardized measures. Cost efficiency is assessed using two measurements: patient total cost and patient episode cost. The physician’s Premium specialty determines which measurement is applied.
The program evaluates physicians annually using updated quality and cost-efficiency methodologies and data. Physicians receive their designations based on a comparison of current version and previous version evaluation results.
View quality conditions and measures or cost efficiency conditions and procedures by Premium specialty. View more detailed information about the Premium program methodology in the following documents: