Medicare Advantage Intermediate Physician Incentive program
The Medicare Advantage Intermediate Physician Incentive (MA-IPi) program rewards you for helping UnitedHealthcare® Medicare Advantage members get the quality care they need.
When you participate in the program, you can earn quarterly bonuses for addressing care opportunities for these members. We determine the bonuses based on our review of feedback from health care professionals like you, as well as the Star Rating measures by the Centers for Medicare & Medicaid Services (CMS).
If there is a conflict between this document and the Terms and Conditions, the MA-IPi Terms and Conditions control.
2024 incentive opportunities
Quality Care Bonuses
We’ll reward you when your patients who are Medicare Advantage members receive annual care visits (ACVs), preventive screenings and medication management. You can earn up to $350 per patient.
| Quality care activity* | Payment per member per activity |
|---|---|
| Breast Cancer Screening (BCS-E) | $20 |
| Osteoporosis Management in Women Who Had a Fracture (OMW) | $20 |
| Kidney Health Evaluation for Patients With Diabetes (KED) | $20 |
| Glycemic Status Assessment for Patients With Diabetes (GSD) | $20 |
| Controlling High Blood Pressure (CBP) | $20 |
| Transitions of Care TRCMRP – Medication Reconciliation Post-Discharge | $20 |
| Statin Therapy for Patients with Cardiovascular Disease (SPC) | $30 |
| Medication Adherence for Diabetes Medications (MAD) | $20 |
| Medication Adherence for Hypertension (RAS Antagonists) (MAH) | $20 |
| Medication Adherence for Cholesterol (MAC) | $20 |
| Statin Use in Persons With Diabetes (SUPD) | $30 |
| Annual Care Visit (ACV) Dates of service: Jan. 1–June 30, 2024 |
$50 |
| Annual Care Visit (ACV) Dates of service: July 1–Dec. 31, 2024 |
$25 |
| Extended Day Prescription - MAD | $20 |
| Extended Day Prescription - MAH | $20 |
| Extended Day Prescription - MAC | $20 |
Suspect Medical Condition Assessment Bonus
Your practice can earn a quarterly bonus when you assess eligible Medicare Advantage members for suspect medical conditions. Eligible members and medical conditions are identified in the Patient Care Opportunity Report (PCOR) and Practice Assist. Practice Assist is also used to document the results of your assessment.
Here’s how it works:
- Earn $15 for each suspect medical condition that you’ve assessed and diagnosed or assessed but were unable to diagnose
- If you diagnose a suspect medical condition, include the appropriate ICD-10 code(s) when you submit the claim
- If you assess but are unable to diagnose the condition, report in Practice Assist that you’re unable to diagnose the suspect condition at the present time. Be sure to include the date of the assessment.
Eligibility
We invite eligible primary care physicians to enroll in the program annually. We’ll send your invitation to participate by mail, which outlines the current year’s bonus opportunities and criteria.
Track your progress
You can use Practice Assist in the Clinical & Pharmacy section of the UnitedHealthcare Provider Portal to monitor your progress. To access the portal, click the Sign In button at the top right of this page. Visit our Provider portal registration page for instructions and training.
Payout dates
| Dates of service | Payment date ** | Payment eligibility |
|---|---|---|
| Jan. 1–March 31 | July 31, 2024 | Quarterly |
| April 1–June 30 | Oct. 31, 2024 | Quarterly |
| July 1–Sept. 30 | Jan. 31, 2025 | Quarterly |
| Oct. 1–Dec. 31 | May 31, 2025 | Quarterly |
| Jan. 1–Dec. 31 | May 31, 2025 | Annual |
Resources
- Prioritize which members should come in for a visit using the Patient Care Opportunity Report or Practice Assist
- PCOR shows which members are due for preventive care including screenings, annual care visits or other exams
- Encourage your patients to come in for a visit. During their visit, schedule the patient’s next appointment at the end.
- Ask patients to provide information about their current specialists, prescription medications and exercise level prior to their visit
- Complete a health risk assessment (HRA) during annual wellness visits
- HRAs help identify barriers to health care such as Social Drivers of Health (SDoH) that include housing, transportation, food insecurity, family circumstances and social support
- Document all SDoH ICD-10 Z codes
- To access the Social drivers of health Z-code provider guide, visit our Social Drivers of Health page
- Coding Corner page
Questions?
If you have questions, please contact your UnitedHealthcare network account representative or practice performance manager. For additional support, visit our Contact us page.
*The information in these columns is subject to change at CMS’ discretion. If CMS retires a HEDIS® Quality Care Measure or moves it to “display status,” we reserve the right to remove it from this bonus opportunity. With the exception of TRCMRP, compensation for care measure closures will be limited to a single compliant closure per member per year.
**We’ll review the provider’s claims and data submissions for the previous quarter(s) and make additional payments, if applicable.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).