Learn how the Bridge Program applies to NYCE PPO, Large Group, and ASO plan members in 2026.
Search
Popular Tasks
Office Visit
Your source for important provider news and updates.
August 13, 2026
Featured Stories
Breast and colorectal cancer screenings are among the most important preventive services providers can offer eligible patients. These screenings help detect cancer early — often before symptoms appear — when treatment may be more effective and outcomes may be improved.
They are also key quality measures within EmblemHealth’s 2026 Quality Incentive Programs (QIP) for both state-sponsored programs and Medicare populations.
Quality incentive opportunity
Potential incentive payments range from:
- State-sponsored programs: $25 – $100 per eligible member
- Medicare: $50 – $150 per eligible member
These measures represent meaningful opportunities to improve patient outcomes while supporting practice quality performance and incentive goals.
How you can help
Providers play a critical role in closing screening gaps. Consider:
- Reviewing care gaps before patient visits.
- Recommending breast cancer screening beginning at age 40 and colorectal cancer screening beginning at age 45 for eligible patients, and referring patients for recommended screenings.
- Reinforcing the importance of completing at-home colorectal screening kits when appropriate.
- Encouraging patients to schedule preventive screenings before leaving the office.
Every completed screening helps improve preventive care, close care gaps, and move quality performance measures closer to target.
For additional information on measure specifications and incentive opportunities, please refer to the 2026 Quality Incentive Program materials or contact your quality engagement strategist at quality_providerengagement@emblemhealth.com.
We recently sent our members an email highlighting the importance of taking medications as prescribed. We included our new medication adherence brochure with information and resources for members to help them stay on their medication schedule.
It is important to ensure your patients understand the importance of taking their medications as prescribed. Adherence to a prescribed medication regimen is essential for achieving desired therapeutic outcomes.
Helpful tips to support medication adherence:
- Switch patients from 30-day fills to 90-day fills for chronic-illness medications.
- Avoid polypharmacy (using multiple, overlapping prescription drugs of the same class/type) by keeping a current medication list. EmblemHealth offers free fillable/printable medication lists in different languages on our Medication Adherence web page.
- Encourage the use of a pillbox and ask if the patient’s pharmacy offers compliance packaging to help them stay adherent. EmblemHealth offers a free pillbox that can be shipped right to the patient’s doorstep.
For contact information, see our Pharmacy Services Contacts.
The American Academy of Pediatrics (AAP) recommends hearing screenings for all newborns. The goal is for all infants to be screened by one month of age; ideally before they leave the hospital.
Hearing problems should be identified by three months of age. Infants who are identified as deaf or hard of hearing should be enrolled in an early intervention program or treatment by the age of six months.
Helpful Tips:
- Obtain chart documents from delivery hospital or perform hearing screening at baby’s first checkup.
- Place electronic medical record (EMR) screening alert flags.
- Obtain parental written informed consent for release of information at first contact with the early intervention program for information to be shared with the primary care physician (PCP).
- Make referrals to the early intervention office in the county of residence, not the county of birth.
When referring to the early intervention program, be sure to include the child’s name and date of birth, complete address, primary language, or the type of communication of the child and parent/legal guardian.
You should also include:
- Parent/legal guardian names and addresses, if different from the child, and phone number(s) (multiple numbers if possible).
- Race/ethnicity.
- Reason for the referral.
- Developmental concerns.
- Hearing status.
- Completed testing results.
- Insurance information.
Learn more from the American Academy of Pediatrics about early hearing detection and intervention.
The follow-up after an emergency department visit for people with multiple high-risk chronic conditions (FMC) HEDIS measure evaluates Medicare members age 18 and older with multiple high-risk chronic conditions who had an emergency department visit, and received a qualifying follow-up visit within seven days of discharge.
We created a new FMC tip sheet for this measure that includes information on qualifying follow-up visits, eligible chronic condition diagnosis, and more.
More women are getting breast cancer at younger ages, making screening more important than ever. The U.S. Preventive Services Task Force and the American Cancer Society advise all women at average risk to begin breast cancer screening at age 40.
We encourage you to speak with your patients between the ages of 40 and 49 about when and how often they should get a mammogram.
The American Cancer Society* guidelines:
- Women age 40 to 44 have the option to start screening with a mammogram every year.
- Women age 45 to 54 should get mammograms every year.
- Women age 55 and older can switch to a mammogram every other year or continue yearly mammograms. Screenings should continue as long as the patient is in good health and is expected to live at least 10 more years.
Compliance and documentation tips
It may also be helpful to have your staff chart-prep and flag patients that need an annual screening order placed during their visit. To help boost compliance, you can offer your patients a “standing order” for their annual screening mammogram, allowing them to complete the screening mammogram before their annual visit with you.
To help you make sure your records meet standards for the Healthcare Effectiveness Data and Information Set (HEDIS) measure, here are a few screening documentation tips to keep in mind:
- Specify “mammogram” and the date of service in the patient history.
- If the exact date is unknown, it’s acceptable to document the month and year. A result is not required.
- Include documentation stating “mammogram completed” and the date of service.
Exclusions:
- Documentation must indicate a bilateral mastectomy any time during the patient’s history through Dec. 31, 2026.
- Documentation in the patient records that a unilateral mastectomy on both the left and right side on the same or different dates of service through Dec. 31, 2026.
- Patients receiving hospice or palliative care any time during the measurement year.
To ensure accurate data capture, when ordering a screening, have your provider credentials co-located with the correct ICD-10 code(s).
Additional resources for providers and members can be found at cdc.gov and at komen.org. Also see recommendations on our member website for breast cancer screening and prevention resources.
JP772679