2024 Provider Quality Incentive Program

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. 

To confirm eligibility for the 2024 Quality Incentive Program please talk to your Provider Network Representative.

Program Requirements

For each incentivized measure by line of business, providers must achieve a minimum 5% rate improvement above 2023 Year End performance (admin) rate to be eligible for payment. Providers performing at 95% or above may also earn payment by achieving a rate of 98%, unless otherwise noted*. 

• If the 5% minimum rate improvement for a measure is achieved, the provider is paid for all gaps closed for that measure in 2024
• Providers below the 5% YOY improvement 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.

* For the Child and Adolescent Well-Care Visits (WCV) incentive, payments are made per gap closed for members who receive care in 2024 and did not pass the measure in MY 2023. To be eligible for payment, the 2024 year end admin rate must be equal to or greater than the 2023 year end admin rate.

* For the Statin Therapy for Patients with CVD (SPC) and Statin Therapy for Patients with Diabetes (SUPD) incentives, payments are made to assess patients for intolerance to certain medications to support PDE exclusions and submit relevant exclusion DX codes