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2018/2019 Premium Methodology

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.