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 & Medicaid Services (CMS).
2024 incentive opportunities
Quality Care Bonus Opportunities
Get rewarded when you see Medicare Advantage members for annual care visits. Earn additional Quality Care Bonuses when you address open care opportunities.
A new Q4 earning opportunity is available.
Achievement Bonus Opportunity
Earn a bonus when you achieve an Average Star Rating of 3.75 or higher.
Improvement Bonuses
Earn a reward when you improve your yearly Average Star Rating. And, get rewarded when you increase your year-end 2024 ACV completion percentage over your year-end 2023 ACV completion percentage.
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, 2024 |
| April 1–June 30 | Sept. 30, 2024 |
| July 1–Sept. 30 | Dec. 31, 2024 |
| Oct. 1–Dec. 31 | May 31, 2025 |
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, 2024 | May 31, 2025 |
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 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
Resources
Questions?
If you have questions, please contact your UnitedHealthcare network account representative or practice performance manager. For additional support, visit our Contact us page.