Sunnyvale Primary Care $($SPC$)$ is considering a P$4$P program to increase preventative care for its

diabetic patients. HbA$1$c is a blood test used to determine how well diabetes is being controlled.

The state medical association recommends that diabetic patients have this test a minimum of two

times per year. In addition, because patients regularly enter and leave primary care practices, the

association considers that a level of $90$ percent of diabetic patients having a HbA$1$c test two times per

year is a reasonable goal for most primary care practices. In the state where SPC is located,

currently only $80$ percent of diabetic patients actually have a HbA$1$c test two or more times per year.

SPC decided on HbA$1$c as a process measure for its P$4$P program and is now considering three

methods of allocating rewards. For each of the measures below, a physician receives a $$5,000$ bonus if:

$-$ the percent of their diabetic patients that had at least two HbA$1$c tests in the past period is

greater than the state average of $80$ percent $($relative performance$).$

$-$ the percent of their diabetic patients that had at least two HbA$1$c tests in the past period is

greater than the state goal of $90$ percent $($benchmark performance$).$

$-$ the difference in the percent of their diabetic patients that had at least two HbA$1$c tests in the past

period compared to the previous period is greater than $10$ percent $($improvement performance$).$