Overview of the Clinical Performance Improvement Initiative pptx format of CPI_description_FY18.pptx

Be sure to consider physician and hospital tiers when choosing a provider.  Employees and Non-Medicare Retirees/Survivors pay the lowest copay for Tier 1 doctors and hospitals.  The GIC’s Clinical Performance Improvement (CPI) initiative gives you an incentive to use doctors with higher quality and/or cost-efficiency scores.  Millions of physician claims are analyzed for differences in how physicians perform on nationally recognized measures of quality and/or cost efficiency.  You pay the lowest copay for the highest-performing doctors:

***Tier 1 (excellent)

 **Tier 2 (good)

  *Tier 3 (standard)

Physicians for whom there is not enough data and non-tiered specialists are assigned a plan’s Tier 2 copay.


! During annual enrollment, check your doctor’s and hospital’s tier, as they can change each July 1 with new data.  Check the health plan websites for physician tiers.

This information provided by the Group Insurance Commission.