5 PROBLEM6(Hint: The key is to use your common sense. You may not need any calculations... Yeah!) 6 Sunnyvale Primary Care (SPC) is considering a P4P program to increase preventative care for its 7 diabetic patients. HbAlc is a blood test used to determine how well diabetes is being controlled. The 8 state medical asociation recommends that diabetic patients have this test a minimum of two times per 9 year. In addition, because patients regularly enter and leave primary care practices, the association 0 considers that a level of 90 percent of diabetic patients have a HbAlc test two times per year is a 1 reasonable goal for most primary care practices. In the state where SPC is located, currently only 80 2 percent of diabetic patients actually have a HbAlc test two or more times per year. 4 SPC decided on HbAlc as a process measure for its P4P program and is now considering three methods 5 of allocating rewards. A physician receives a bonus of $5000 if: 6-the percent of their diabetic patients that had at least two HbAlc tests in the past six months is greater 7 than the state average of 80 percent (relative performance 8 -the percent of their diabetic patients that had at least two HbAlc tests in the past six months is greater 9 than the state goal of 90 percent (benchmark performance). 0 -the difference in the percent of their diabetic patients that had at least two HbAlc tests in the past six 21 to the previous six months months is greater than 10 percent (improvement performance). 23 The percent of diabetic patients that had at least two HbAlc tests in the past year for each SPC physician 24 is shown below