Since the launch of Medicaid Transformation on July 1, 2021, UnitedHealthcare Community Plan of North Carolina instituted 2 provider partner incentive programs:
The CP-PCPi program offers eligible provider partners the opportunity to earn financial incentives for helping their patients who are plan members become more engaged in their preventive health care.
Qualifying physician practices can earn rewards based on the number of patient care opportunities closed for certain Healthcare Effectiveness Data and Information Set (HEDIS®) measures, including:
The CP-HEPi rewards eligible Advanced Medical Home (AMH) providers for helping reduce health inequities associated with racial and ethnic identities.
CP-HEPi focuses on positive outcomes tied to preventive measures among underserved populations, including:
CP-HEPi aligns with the North Carolina Medicaid Managed Care Quality Strategy to promote equity through reduction or elimination of health disparities.
Participating practices must have a minimum of 100 assigned UnitedHealthcare Community Plan members (tax ID number (TIN) level) to be eligible. Notification letters will be sent to providers who meet this threshold. Advanced Medical Home (AMH) Tier 3 practices do not have a minimum assigned panel requirement.
If a CP-PCPi or CP-HEPi Payment is earned, we’ll send your practice an estimated payment no later than March 31, 2023. We’ll send a final payment less the amount of the estimated payment no later than Sept. 30, 2023.
The following online resources will provide you with a better understanding of care opportunities