Make Quality Pay Program

PCP Dental Incentive Program

Reminder:

There is a dental incentive plan for YourCare members 2-20 years of age. These members are required to receive a dental visit by their assigned dentist at least once per year.

The basic design of the program is for Healthplex to provide Primary Care Professionals such as yourself a listing of all members assigned to your office who have not had a dental visit in 2017. You will receive an incentive bonus of $5.00 for each member you see and recommend that they visit their dentist, and you will receive an additional $15.00 for each of those members who actually visit the dentist this calendar year.

When Healthplex receives a card from your office, a $5.00 incentive will immediately be set aside for you, and the receipt for the card will be entered into the Healthplex database. This will allow Healthplex to track how many doctors are responding to the program, and to track which members have gotten the referral portion of the card. It will also be the trigger for searching for dental visits to pay you the additional $15.00.  Your incentive bonus payment for this dental program will be paid out in the first quarter of 2018, once we are able to ascertain utilization for these members.

Both YourCare and Healthplex are extremely optimistic about this initiative.  In past years, it has proved to be a simple and timely way to improves this population's access to dental care, and we expect it will be successful this year as well.

We appreciate your cooperation. Should you have any questions regarding this program and how it operates, you may contact Clair Murphy, Government Outreach Associate at Healthplex, at 1.516.740.4810, or via email at cmurphy@healthplex.com.

 

Make Quality Pay Program

At YourCare Health Plan, we believe you should be rewarded for helping patients live healthier. That’s why we’ve designed the Make Quality Pay Program (MQPP). To reward and recognize practitioners who provide high-quality, cost-effective care to their patients and submit accurate health data reflecting that care.

MQPP promotes a goal we all support: quality healthcare for individuals and families who are served by government-sponsored programs. YourCare Health Plan is committed to this incentive program and will work actively with you and your staff to help you realize its full potential.

As part of the MQPP YourCare offers the Healthy Beginnings Incentive Program that  rewards providers for the demonstration of quality care according to QARR/HEDIS standards.  The information that you provide enables us to follow our members from prenatal through postpartum care. 

Working together, we can promote healthier individuals and families.

For measure specific information please see the MQPP Measure & Tip Sheets:

Measure Sheet-Pediatric MQPP 

Measure Sheet-Multi Specialty MQPP 

Tip Sheet- Adolescent Preventive Care (NYS-APC)

Tip Sheet-Weight Assessment and Counseling for Nutrition and Exercise (WCC)


Committed to Your Success

YourCare Health Plan will generate monthly reports based on claim data, which provide practices with a scorecard to indicate progress.

If you’re concerned your practice doesn’t have the resources to participate in the program, we can help. YourCare Health Plan is committed to helping all participating practices through education and training programs, including:

  • Practice Outreach and Education Program. Leverages NYS Quality Measures that can be most effectively improved via support for and collaboration with primary care practices and providers. The program includes practice-specific data-analytical support, coding analysis/education, outreach and RN care coordination. The goal is to target and impact the preventive and follow-up visits that are most likely to improve members’ healthcare. This is achieved through a team approach, which includes a dedicated Certified Professional Coder (CPC), Quality Coordinator and RN Care Coordinator.


Rewards & Deadlines

YourCare Health Plan has successfully offered this program in other regions in upstate New York. The exact details of the program’s goals and bonuses will be reviewed with each participating practice and our staff will work closely with your practice to help you attain a reward.

Organizationally, we have recognized Primary Care Providers in the Western NY and Finger Lakes Region with three million dollars in Quality Incentive awards. 

2017 MQPP Deadlines
The MQPP measurement period for 2017 is January 1, 2017, through December 31, 2017, and the final due date for all 2017 performance data will be April 30, 2018.


Have more questions?

For more information, please contact our Quality Matters team. We’ll schedule a meeting to review the program in more detail and discuss the potential bonus reward for your practice.