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Medicare Advantage Intermediate Physician Incentive program

The Medicare Advantage Intermediate Physician Incentive (MA-IPi) program rewards you for helping your patients who are UnitedHealthcare® Medicare Advantage members get the quality care they need. These patients are also referred to as MA-IPi Customers.

When you participate in the program, you can earn quarterly and annual bonuses for addressing care opportunities for these patients. In 2026, you can also earn additional bonuses for assessing members and their suspect medical conditions.

We determine the bonuses based on our review of feedback from health care professionals like you, as well as Star Rating measures from the Centers for Medicare & Medicaid Services (CMS).

2025 MA-IPi information and dates

2026 incentive opportunities 

Quality Care Bonuses

We’ll reward you when you see your patients, who are Medicare Advantage members, to address Standard Quality Care measures and Key Care Opportunities. Key Care Opportunities identify specific quality care gaps for your members in need of recommended screenings, follow-ups, preventative care and medication management.

Quality Care Measure name1 Standard Eligible Payment per Care Measure Closure4 Key Care Opportunity Payment per Care Measure Closure4
Osteoporosis Management in Women Who Had a Fracture (OMW) $50 $250
Statin Use in Persons with Diabetes (SUPD) $20 $250
Breast Cancer Screening (BCS-E) $10 $250
Eye Exam for Patients with Diabetes (EED) $10 $250
Controlling High Blood Pressure (CBP)3 $10 $150
Colorectal Cancer Screening (COL-E) $10 $150
Glycemic Status Assessment for Patients with Diabetes (GSD)3 $10 $150
Kidney Health Evaluation for Patients with Diabetes (KED) $10 $150
Medication Adherence for Cholesterol (Statins) (MAC) 3 $10 $150
Medication Adherence for Diabetes Medications (MAD)3 $10 $150
Medication Adherence for Hypertension (RAS antagonists) (MAH) 3 $10 $150
Key Care Annual Care Visit (Key Care ACV) N/A $100
Fall Risk Management (FRM) N/A $20
Management of Urinary Incontinence in Older Adults (MUI) N/A $20
Follow-up after Emergency Department Visit for Patients with Multiple Chronic Conditions (FMC)2 $25 N/A
Medication Reconciliation Post-Discharge (MRP)2 $25 N/A

Medical Condition Assessment Bonus

Your practice can earn on 3 bonus opportunities when you submit an Assessment and documentation for member visits. Your office will receive member Assessment information from Optum.

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You’ll be eligible to receive a Medical Condition Assessment Bonus payment for submitting an assessment and documentation, in compliance with the MA-IPi Terms and Conditions, of one or more face-to-face comprehensive exams in 2026.

 

Here’s how it works:

  • We’ll pay you $25 for an Assessment returned within 60 days of the latest date of service submitted
  • You’ll be eligible for $15 for each Assessment received after 60 days of the latest date of service submitted
  • You’ll be eligible for a MA-IPi Assessment Bonus of $15 when documentation of 1 or more face to face comprehensive exams occurs prior to when you receive an Assessment
  • Submissions received after Jan. 31, 2027, will not be eligible for the MA-IPi Assessment Bonus
  • Compensation for the Medical Condition Assessment Bonus will be limited to a single returned assessment per member per year

You’ll be eligible to receive the Fully Assessed Bonus of $75 for MA-IPi Customers when you review all Suspect Medical Conditions during a care visit within the MA-IPi Term.

 

How it works

  • You must provide documentation of one or more face-to-face comprehensive exams in 2026
  • You must complete and return all pages of the Assessment and a medical record to support all existing chronic conditions and co-morbid factors, documented to the highest level of specificity
    • Medical records must include: Date of service, provider name, credentials and a valid signature must appear at the end of each documented MA-IPi Customer visit. Your patient’s name and date of birth must be present on all pages of the medical record.
  • An Assessment must have a documented action for all conditions included on the Assessment to be considered fully assessed.  Eligible actions in the Assessment are defined as:
    • Assessed and present: Must be documented to the highest degree of specificity in the medical record submitted to Optum
    • Assessed and unable to diagnose at this time: You’ve assessed the patient for the suspected condition and did not find evidence of it at the time of the visit
    • Referred: The patient is assessed and referred to another provider for further evaluation and/or management of the condition

Earn an additional annual bonus by submitting valid Assessments for at least 70% of your patients who have an Assessment generated by Optum during the MA-IPi term.

 

Payment based on MA-IPi Assessment return rate

Percentage of MA-IPi assessment return rate Medical Condition Assessment Superior Bonus
(Per valid Assessment noted in the final reporting)
90%-100% $40 PMPY
80%-89% $20 PMPY
70%-79% $10 PMPY
69% and below $0 PMPY

Eligibility

Each year, we invite eligible primary care physicians to enroll in the program. You'll receive an invitation to participate by mail that details the current year's bonus opportunities and criteria.

Track your progress

You can use Practice Assist or your Patient Care Opportunity Report (PCOR) to monitor your progress toward these incentive opportunities and use your Key Measure Opportunity Report (KMOR) in Practice Assist to identify which members need a visit. It’s available in the UnitedHealthcare Provider Portal in the Clinical & Pharmacy dropdown menu. To access the portal, click Sign In in the upper right corner of this page.

Payout dates

Dates of service Payment date4 Payment eligibility
Jan. 1–March 31, 2026 July 31, 2026 Quarterly
April 1–June 30, 2026 Oct. 31, 2026 Quarterly
July 1–Sept. 30, 2026 Jan. 31, 2027 Quarterly
Oct. 1–Dec. 31, 2026 May 31, 2027 Quarterly
Jan. 1–Dec. 31, 2026 May 31, 2027 Annual

Resources

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  • Explore the 2026 MA-IPi Welcome Kit for everything you need to know about this year’s program
  • Prioritize which patients should come in for a visit by accessing your KMOR in Practice Assist or Patient Care Opportunity Report (PCOR)
    • KMOR shows which patients have Key Measure Opportunities and are due for preventive care, including screenings, follow-ups and medication management
    • PCOR provides a monthly look at performance in quality measures as well as members with open care gaps to be addressed
  •  Encourage your patients to come in for a visit and schedule their next appointment before they leave
  • Ask patients to provide information about their current specialists, prescription medications and exercise level prior to their visit
  • Assess Suspect Medical Conditions identified on the Assessment information provided by Optum. Make sure to submit the Assessment within 60 days of the members visit with necessary medical records to maximize this bonus opportunity.
  • Complete a health risk assessment (HRA) during annual wellness visits

Questions? We’re here to help.

If you have questions, please contact your UnitedHealthcare representative or Provider Performance Team. For chat options and contact information, visit our contact resources.

If there is a conflict between this page and the Terms and Conditions, the MA-IPi Terms and Conditions control.

1The information in these columns is subject to change at CMS’ discretion. If CMS retires a Quality Care Measure or moves it to “display status,” United reserves the right to remove it from this bonus opportunity.

2With the exception of TRCMRP and FMC, compensation for care measure closures will be limited to a single compliant closure per member per year.

3CBP, GSD, MAC, MAD and MAH are eligible for payment annually only. All other measures are paid out quarterly.

4To ensure that the provider is reimbursed as outlined, we’ll review the provider’s claims and data submissions for the previous quarter(s) and make additional payments, if applicable.