Take Advantage of
Provider Incentive Programs!

Learn more about our 2016 Primary Care Physician Incentive Award Program and find out if you qualify to receive an incentive for the quality care you provide to our members.

Please note: Below applies only to services completed during calendar year 2015.

Quality Management – HIP Medicaid/CHP is offering incentives to fee-for-service and AdvantageCare Physicians (ACPNY) providers for completing services and closing gaps in care. There are two components to the incentive program:

  • A maternal provider incentive that offers $250 for completing all prenatal and postpartum visits for Medicaid/CHP members.
  • An HIV/AIDS provider incentive that offers providers the opportunity to earn $100 for each fully compliant member in 2015.

The table below provides additional, detailed information on both incentives.

Maternal Provider Incentive HIV/AIDS Provider Incentive
HEDIS Measures Prenatal and Postpartum Care and Frequency of Ongoing Prenatal Care
HIV/AIDS Comprehensive Care
Line of Business
Medicaid/CHP Medicaid/CHP
Eligible Providers FFS and ACPNY Obstetricians/Gynecologists Prescribing Providers of Anti-Viral medication to Medicaid members with HIV/AIDS
Eligible Member Population All Pregnant Members All Members with HIV/AIDS
  1. Member must complete an initial prenatal visit in her first trimester.
  2. Member must complete 81% of her prenatal visits during the course of the pregnancy.
  3. Member must complete a postpartum visit within 21 to 56 days of giving birth.
  4. Provider must submit medical records within 60 days post-delivery for each pregnancy.
  1. Two Engaged in Care Visits: First Visit between January 1st and June 30th. Second Visit between July 1st and December 31st.
  2. Two Viral Load Monitoring Tests: First Test between January 1st and June 30th. Second Test between July 1st and December 31st.
  3. Yearly Syphilis Screening.
  1. $50 for initial prenatal care visit
  2. $150 for 13 or more prenatal visits during the course of the pregnancy
  3. $50 for postpartum care visit
Incentive is based on overall performance in all three sub-measures. Providers will earn $100 per member for completing all engaged in care visits, viral load monitoring and a syphilis screening.
Payout Timeline
Within 8 – 12 weeks of medical record submission
End of the year