Set Cost and Utilization Targets

Set cost and utilization targets for a contract.

You can set cost and utilization targets for your contract in the Contracts section of Oracle Health Quality Management. Targets are established in the hard copy of the contract, but entering them into Oracle Health Quality Management allows you to track your targets against real-time data, and identify progress toward your goals.

To set cost and utilization targets:

1. From the Contracts tab, select Edit Target Plan next to the contract you want to edit. The target tool is displayed, and the cost and utilization targets page is displayed.
2. Select Edit Target for the contract metric for which you want to set a target, incentive, or contract gate. The contract metric page is displayed.
3. Select one of the following options from the Target Type menu:
   • Simple Completion Percentage
   • Simple Completion Number
   • Tiered Completion Percentage
   • Tiered Completion Number
4. From the Target Value field, enter a target value.
5. If available, select an option from the Desired Trend menu. Some metric's trends are predefined and cannot be changed.
6. From the Payout Type menu, select one of the following options:
   • Per member per month (PMPM)
   • Per member per year (PMPY)
   • Lump sum
   • Per Care Gap Measure Closure
7. In the Payout Values field, enter a payout value.
8. Enter an organizational goal, if applicable.
9. Set the Contract Gate field to Yes or No, depending on whether the metric acts as a contract gate.
10. Select Save to save your changes. 
11. If you want to remove targets from the metric, select Clear Target.