Incentive payment updates for PCPs participating in our value-based programs

May 21, 2020

Independence is committed to looking at ways to support our participating network providers during this unprecedented time in health care due to the COVID-19 pandemic. We understand the administrative burden and financial stress this is putting on your practices, and we want to help you continue to provide high-quality health care to our members, your patients in this uncertain time.

To support Independence-participating providers with their cash-flow needs during the COVID-19 national emergency, Independence will be accelerating the incentive payments to those eligible primary care physicians (PCP) who participated in the Quality Incentive Payment System (QIPS) program, Preventive and Quality Improvement Program (PQIP), and Primary Care Advancement Model (PCAM) for measurement year 2018 and measurement year 2019.

Incentive payments

Below is a detailed plan of the payment changes for the QIPS program/PQIP/PCAM.

  • Measurement year 2018: Incentive payments for our HMO Quality Performance Measure (QPM) score program/Quality Program incentive payments were accelerated. Eligible PCPs should have received their incentive payments for the remainder of measurement year 2018, which was processed and distributed in early May. 

​This lump sum payment includes those incentives earned and scheduled to have been paid in the subsequent months of June and July and completes the remaining payments for the QPM score program/Quality Program for measurement year 2018.

  • Measurement year 2019: We will be accelerating the QIPS program, PQIP, and PCAM incentive payments to help alleviate some of the financial strain that practices are experiencing during this time. HMO QPM payments that are typically reimbursed monthly from August 2020 – July 2021 will be reimbursed in one annual payment in June 2020. Therefore, incentive payments for PCP practices will be paid as follows:
  • Incentive program Original payment date Accelerated payment date

    QPM score program/Quality Program HMO/PPO

    August 2020

    June 2020*

    Medication Compliance and Pharmacy Cost

    October 2020

    August 2020

    Total Cost Efficiency HMO/PPO

    October 2020

    August 2020

    Care Efficiency Management

    October 2020

    August 2020

    *These lump sum payments will represent the complete incentive payouts for the QIPS program, PQIP, and PCAM for measurement year 2019.

Please note that the payments made as outlined above will be considered “final” payments for measurement year 2018 and measurement year 2019.

Feedback

In consideration of the impact COVID-19 has had on staffing levels at PCP practices (i.e., reduced/limited office staff, office closures) and the accelerated payment timeline, the standard feedback process associated with the QPM score program/Quality Program will not be available for measurement year 2019.

Reports

All program reports that outline your performance in the QIPS program, PQIP, and PCAM are available on IndexProTM via the Provider Engagement Analytics and Reporting (PEAR) portal. Registration with IndexPro is a prerequisite for the QIPS program, PQIP, and PCAM as outlined in the measurement year 2019 program manuals.

If your practice has not registered for the PEAR portal or if your access has not yet been granted, your reports will be mailed to you. However, we encourage you to review the information outlined on our dedicated PEAR portal webpage so you can access future reports.

Note: If you are part of an Integrated Delivery System, you will need to contact your Organization Administrator for access to IndexPro and permission to view the reports. 

Reports for the incentive programs outlined above will be available in the Output Manager section, accessible from the top navigation menu.

Questions

We thank you for your continued commitment to providing high quality health care to our members, your patients.

If you have concerns about your score or the content of this article, please contact your population health specialist or your network medical director: Dr. Ronald Brooks, Dr. Dale Mandel, or Dr. Ellen Riccobene.