Medicare Advantage Primary Care Physician Incentive program
The Medicare Advantage Primary Care Physician Incentive (MA-PCPi) program rewards you for helping UnitedHealthcare® Medicare Advantage members get the quality care they need to live healthier lives.
When you participate in the program, you can earn quarterly and annual bonuses for addressing care opportunities for these members. The bonus opportunities are established each year. They’re based on our review of feedback from health care professionals like you, and on prioritization of Star measures by the Centers for Medicare and Medicaid Services (CMS).
2023 incentive opportunities
Eligibility
We invite eligible primary care physicians to enroll in the program annually. Your invitation to participate is sent by mail and outlines the current year’s bonus opportunities and criteria.
Track your progress
You can use Practice Assist to monitor your progress toward these incentive opportunities. It’s available on the UnitedHealthcare Provider Portal in the Clinical & Pharmacy section. To access the portal, click Sign In in the upper right corner of this page, then log in with your One Healthcare ID and password. If you don’t have an ID and password, you can register for one
Payout dates
| Quarterly bonus opportunity | |
|---|---|
| Dates of ACV | Payment date |
| Jan. 1 - March 31 | June 30, 2023 |
| April 1 - June 30 | Sept. 30, 2023 |
| July 1 - Sept. 30 | Dec. 31, 2023 |
| Oct. 1 - Dec. 31 | May 31, 2024 |
To help ensure the provider is reimbursed as outlined, UnitedHealthcare will review the provider's claims and data submissions for the previous quarter(s) and make additional payments, if applicable. |
|
| Annual bonus opportunities | |
|---|---|
| Dates of service | Payment date |
| Jan. 1 – Dec. 31, 2023 | May 31, 2024 |
Tips for success
- Prioritize which members should come in for a visit using the Patient Care Opportunity Report (PCOR) or Practice Assist
- PCOR shows which members are due for preventive care including screenings, annual care visits or other exams. Review the self-paced training for more details and instructions.
- Reach out to encourage 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 Determinants of Health (SDoH) that include housing, transportation, food insecurity, family circumstances and social support
- Document all SDoH ICD-10 Z codes
- See our overview of SDoH protocol
- For commonly used Z codes, see pages 13-14 of our UnitedHealthcare Quality Reference Guide
- For more information, refer to our 2023 Medicare Advantage Preventive Screening Interactive Guide
Resources
Questions?
Contact your UnitedHealthcare representative if you have questions or need more information.