2025 Provider Quality Incentive Program
MVP Health Care® introduces its 2024 Quality Incentive Program, enabling eligible providers to earn incentives by providing exceptional care to MVP Members.
Program Overview
MVP Health Care® (MVP) is excited to announce its 2025 Quality Incentive Program, offering eligible Participating Providers the opportunity to earn incentives by delivering high quality health care to MVP Members during calendar year 2025, and submitting appropriate coding.
2025 Measures and Targets
-
Medicaid
Measure/Link
to MVP
tip sheetMeasure Description
2.5% Rate
Improvement
Target5% Rate
Improvement
Target7.5% Rate
Improvement
TargetPayment per
improvement
gap closedPayment per
improvement
gap closedPayment per
improvement
gap closedMetabolic Monitoring for Children and Adolescents on Antipsychotics
$125
$175
$175
Breast Cancer Screening
$125
$175
$175
Controlling Blood Pressure
$125
$175
$175
Cervical Cancer Screening
$125
$175
$175
Chlamydia Screening
$125
$175
$175
Colorectal Cancer Screening
$125
$175
$175
Developmental Screening in the First Three Years of Life
$125
$175
$175
DSF
Depression Screening and follow Up
$50
$50
$50
Diabetes Care – Eye Exam
$125
$175
$175
Glycemic Status Diabetes
$125
$175
$175
Immunizations for Adolescents
$125
$175
$175
Diabetic: Kidney Health Evaluation
$125
$175
$175
Well-Child Visits in the First 30 Months of Life
$125
$175
$175
-
Essential Plan
Measure/Link
to MVP tip
sheetMeasure Description
2.5% Rate
Improvement
Target5% Rate
Improvement
Target7.5% Rate
Improvement
TargetPayment per
improvement
gap closedPayment per
improvement gap closedPayment per
improvement gap closedAIS
Adult Immunization Status- Influenza
$50
$50
$50
Breast Cancer Screening
$125
$175
$300
Controlling Blood Pressure
$200
$250
$375
Cervical Cancer Screening
$125
$175
$300
Chlamydia Screening
$125
$175
$300
Colorectal Cancer Screening
$125
$175
$300
DSF
Depression Screening and follow Up
$50
$50
$50
Diabetes Care – Eye Exam
$125
$175
$300
Glycemic Status Diabetes
$200
$250
$375
Diabetic: Kidney Health Evaluation
$125
$175
$300
Social Need Screening and Intervention
$50
$50
$50
-
HARP
Measure/Link
to MVP tip
sheetMeasure Description
2.5% Rate
Improvement
Target5% Rate
Improvement
Target7.5% Rate
Improvement
TargetPayment per
improvement gap closedPayment per
improvement gap closedPayment per
improvement
gap closedAIS
Adult Immunization Status Influenza
$50
$125
$125
Breast Cancer Screening
$50
$125
$125
Controlling Blood Pressure
$50
$125
$125
Cervical Cancer Screening
$50
$125
$125
Diabetes Care – Eye Exam
$50
$125
$125
Glycemic Status Diabetes
$50
$125
$125
SPC
Statin Therapy for Patients with CVD
$50
$125
$125
-
Medicare
Measure/Link
to MVP tip
sheetMeasure Description
2.5% Rate
Improvement
Target5% Rate
Improvement
Target7.5% Rate
Improvement
TargetPayment per
improvement
gap closedPayment per
improvement
gap closedPayment per
improvement
gap closedBreast Cancer Screening
$100
$200
$500
Controlling Blood Pressure
$100
$200
$500
Colorectal Cancer Screening
$100
$200
$500
Diabetes Care – Eye Exam
$100
$200
$500
Glycemic Status Diabetes
$100
$200
$500
Diabetic: Kidney Health Evaluation
$100
$200
$500
MAC
Medication Adherence: Cholesterol
$100
$200
$500
MAD
Medication Adherence: Diabetes
$100
$200
$500
MAH
Medication Adherence: Hypertension
$100
$200
$500
Statin Therapy for Patients with Cardiovascular Disease
$100
$200
$500
Statins Use with Diabetes
$100
$200
$500
Medicare Priority Member Bonus: An additional $100 bonus is available for each MVP identified priority member gap closed, once improvement target is reached
Provider Eligibility Requirements
Providers currently contracted in an existing value-based arrangement or quality incentive contract with MVP are ineligible for the QIP for those measures by LOB where currently contracted for.
A minimum denominator size of 30 for per incentivized measure is required to be eligible for incentive payment. To confirm eligibility for the 2025 Quality Incentive Program please talk to your Provider Network Representative.
Program Requirements
To qualify for payments, 2025 (administrative) year-end performance per incentive eligible measure must be at least 2.5% above 2024-year end rate. Payment is based on each incremental improvement gap closed above the target rate; not all care gaps closed.
- Once the rate improvement target is achieved, MVP will pay per improvement gap closed in 2025, above 2024-year end rate
- Year-end Performance below the improvement rate targets receive $0 payout for that measure
- Upon completion of care, providers must submit the claim or supplemental data file containing all required codes to achieve performance improvement and receive payment.
Measurement Period and Payment
Incentive payments will be made one time by the end of Q2 2026.
Payment is based on each eligible (attributed) patient who receives services, or claims we receive for services rendered for dates of service between January 1, 2025, and December 31, 2025. MVP must receive all claims by March 31, 2026.
Quality Reports
Find quality reports at the practice site level in your Provider online account.