Rewarding Providers for Great Patient Care
HealthCare Partners (HCP) is committed to improving the health of our members by working closely with our Primary Care Providers. The goals of our incentive programs are to improve clinical outcomes and patient satisfaction, which will deliver value to all of our partners.
Just Announced: The 2024 Provider Incentive Program
HCP is pleased to offer the 2024 Provider Incentive Program. The purpose of this incentive is to reward providers for delivering high-quality healthcare, properly documenting care in their patients’ medical records, and submitting the associated claim and encounter data.
Medicare Advantage Incentive for Emblem & Empire Patients
Part 1: Complete Annual Wellness Visits (AWVs) or HCP Patient Assessment Form
The purpose of this incentive is to reward providers for delivering high-quality prospective health assessments where all new and chronic conditions are assessed, managed, and documented properly.
Payment Frequency
Quarterly
Part 2: 3x Patient Visit Bonus
Medicare-aged patients who see their PCP at a regular, pre-determined cadence (i.e. quarterly) experience improved disease management and higher rates of preventative screenings. These patients are less likely to go to the ED or get admitted with ambulatory-sensitive or newly emergent symptoms.
Payment Frequency
Final measurement year reconciliation paid in 2025
Part 3: 7-Day Post-Discharge Visits with Medication Reconciliation
Patients who receive PCP follow-up and medication reconciliation within 7 days of hospital discharge are significantly less likely to be readmitted.
Payment Frequency
Quarterly
Part 4: Star Measures Closed
- Breast Cancer Screening
- Care for Older Adults – Pain Assessment
- Care for Older Adults – Medication Review
- Colorectal Cancer Screening
- Controlling High Blood Pressure
- Diabetes Care – Blood Sugar Controlled (A1c<9)
- Diabetes Care – Retinal Eye Exam
- Medication Adherence for Cholesterol (Statins)
- Medication Adherence for Diabetes Medications
- Medication Adherence for Hypertension
- Medication Reconciliation Post-Discharge
- Statin Therapy for Patients with Cardiovascular Disease
- Statin Use in Persons with Diabetes
Eligible Submission
Measures are paid as patients achieve compliance in accordance with current HEDIS® specifications.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
Payment Frequency
Quarterly
Bonus Incentive Opportunity: Preferred Specialists Referral Program
Utilizing vetted preferred specialists facilitates better coordination of patient care and high-quality outcomes, along with higher satisfaction of care experience. Receive additional incentives when you refer your patients to our preferred network for NEW specialist referrals.
Payment
Final year reconciliation period in 2025
Primary Care Physician Gainsharing
Gain share positions the PCP as a partner in value without downside financial exposure. The goal is to reward providers for their contributions to improving care and reducing preventable medical costs.
Gainsharing
Exceed network Medical Loss Ratio and Quality targets, and earn gain share back to qualifying PCPs.
Payment
Q3 2025
Medicaid Incentive
Primary Care Physician Gainsharing
Gain share positions the PCP as a partner in value without downside financial exposure. The goal is to reward providers for their contributions to improving care and reducing preventable medical costs.
Gainsharing
Exceed network Medical Loss Ratio and Quality targets, and earn gain share back to qualifying PCPs.
Payment
Q3 2025
Commercial Incentive
Patient Post-Discharge Visits
Commercial patients who receive PCP follow-up and medication reconciliation within 7 days of hospital discharge are significantly less likely to be readmitted.
Patient Visit Bonus
Post-discharge visit completed within 7 days of hospital discharge with medication reconciliation.
Payment Frequency
Quarterly
Resources and Dedicated Staff are Available to Help you Achieve your Goals
Quality resources are available to assist with properly documenting patient care in medical records, and for submitting the associated claim and encounter data with the appropriate codes.
Find Documenting M.E.A.T., SOAP Notes, AWV forms, and other helpful tools and education on our Quality Tools webpage.
Our dedicated staff including quality specialists, clinicians, and coders are here to support you with programs, education, assessments, and technology.
Questions About the Incentive?
Contact your Provider Relations Specialist for any questions regarding this incentive.
