Tier 1, 2 and 3 measurements for FCHP Select Care

Fallon Community Health Plan is committed to giving all our members access to a network of high-quality, cost-efficient plan physicians. All tiering is based on quality and cost-efficiency measures, with the exception of the following specialties which are based on cost-efficiency measures only: gastroenterology, hematology/oncology, orthopedics and podiatry. The tiering works as follows:

***Tier 1 (excellent): This tier includes plan physicians practicing at an excellent level of quality and cost-efficiency. You will pay the lowest copayment when you see a Tier 1 plan physician.

**Tier 2 (good): This tier includes plan physicians practicing at a good level of quality and cost-efficiency, or a plan physician with insufficient cost-efficiency or quality data. You will pay the prevalent (mid-level) copayment when you see a Tier 2 plan physician.

*Tier 3 (standard): This tier includes plan physicians practicing at a standard level of quality and cost-efficiency. You will pay a higher copayment when you see a Tier 3 plan physician.

NT/ID: This designation includes providers that did not have sufficient data for tiering and providers that belong to a specialty or subspecialty that is not being tiered by FCHP. These specialists are subject to a $35 copayment.