UnitedHealthcare is committed to providing physicians with actionable, patient-specific information that will help them deliver the best possible clinical care while empowering them to meet personal and professional goals through our Physician Performance Based Compensation Program (PPBC).
This program includes the Patient Care Opportunity Reports (PCOR), the Patient-Centered Medical Home Program (PCMH), the Primary Care Physician Incentive Program (PCPi), Quality Provider Incentive Program (QPIP) and Outpatient Procedure Incentive Program (OPIP).
You can access reports in the UnitedHealthcare Provider Portal under the Documents & Reporting drop-down menu.
Need help using the report tool? Check out our resources on UHCprovider.com/portal.
The Patient Care Opportunity Report (PCOR) provides clear and actionable information for physician groups and organizations to use to identify their patients’ adherence to preventive screenings, treatments and medications.
The UnitedHealthcare PCOR shows which of our members are due for preventive care including screenings, well care visits or other exams. The information is based on claims and pharmacy records, and can help you close care opportunities, including those related to pharmacy compliance, tied to Healthcare Effectiveness and Data Information Set® (HEDIS) measures and Centers for Medicare & Medicaid Services (CMS) guidelines.
First Time Accessing a PCOR Report?
If this is your first time accessing your report, please use your PIN to log in. If you don’t know your PIN, please contact your UnitedHealthcare Network Account Manager or your Provider Advocate.
The same PIN works for the Medicare Advantage, Medicaid and Commercial and Exchange reports.
UnitedHealthcare’s disciplined approach to payment reform leverages years of experience with incentive-based contracting models.
One component of this overall strategy is the Physician Performance-Based Compensation (PPBC) program, which provides an incentive to medical groups for quality and efficiency improvements in the delivery of health care affecting the overall health of UnitedHealthcare Commercial members and cost of health care.
Patient-Centered Primary Care Collaborative (PCPCC) is a great resource for finding both general information about the principles and value of the medical home as well as specific guides for different stakeholders.
National Committee for Quality Assurance (NCQA) is a resource for recognition programs including a program for medical home recognition.
Name of program
Quality-Based Physician Incentive Program (QPIP) & Quality-Based Shared Savings Program (QSSP)
Description of the programs
Quality-Based Physician Incentive Program (QPIP) & Quality-Based Shared Savings Program (QSSP)
The Quality-Based Physician Incentive Program (QPIP) provides physicians the opportunity to earn an incentive payment by performing clinically appropriate procedures at designated facilities and meeting certain quality metrics.
The Quality-Based Shared Savings Program (QSSP) provides physicians in California the opportunity to join other care providers and share a quarterly distribution for savings earned by performing clinically appropriate procedures at designated facilities and meeting certain quality metrics.
First Time Accessing a QPIP/QSSP Report?
If this is your first time accessing your report, please use your PIN to log in. If you don’t know your PIN, please email the QPIP/QSSP team at west_lab_inquiry@uhc.com.
Need Help with Your Reports?
If you have any questions about the UnitedHealthcare Provider report package or the QPIP/QSSP program or assistance in accessing reports, please contact QPIP/QSSP team at west_lab_inquiry@uhc.com.
Name of program
Outpatient Procedure Incentive Program
Description of the program
The Outpatient Procedure Incentive Program (OPIP) is a commercial invitation-only incentive program that encourages providers to perform clinically appropriate services at high quality and high efficiency ambulatory surgery centers.
Accessing a QPIP/QSSP report
If it’s your first time accessing this report:
If you don’t know your PIN:
Questions?
If you have questions or need assistance accessing the reports, email the OPIP team at OPIP@uhc.com.
If you have any questions about the UnitedHealthcare Physician Performance Based Compensation program or need additional information, please contact your Network Management Contract Representative or Provider Advocate.
Questions? We’re here to help.
Connect with us through chat 24/7 in the UnitedHealthcare Provider Portal. For additional contact information, visit our Contact us page.