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 sheet

    Measure Description

    2.5% Rate
    Improvement
    Target

    5% Rate
    Improvement
    Target

    7.5% Rate
    Improvement
    Target

       

    Payment per
    improvement
    gap closed

    Payment per
    improvement
    gap closed

    Payment per
    improvement
    gap closed

    APM-E

    Metabolic Monitoring for Children and Adolescents on Antipsychotics

    $125

    $175

    $175

    BCS-E

    Breast Cancer Screening

    $125

    $175

    $175

    CBP

    Controlling Blood Pressure

    $125

    $175

    $175

    CCS

    Cervical Cancer Screening

    $125

    $175

    $175

    CHL

    Chlamydia Screening

    $125

    $175

    $175

    COL-E

    Colorectal Cancer Screening

    $125

    $175

    $175

    DEV

    Developmental Screening in the First Three Years of Life

    $125

    $175

    $175

    DSF

    Depression Screening and follow Up

    $50

    $50

    $50

    EED

    Diabetes Care – Eye Exam

    $125

    $175

    $175

    GSD

    Glycemic Status Diabetes

    $125

    $175

    $175

    IMA

    Immunizations for Adolescents

    $125

    $175

    $175

    KED

    Diabetic: Kidney Health Evaluation

    $125

    $175

    $175

    W30

    Well-Child Visits in the First 30 Months of Life

    $125

    $175

    $175

  • Essential Plan

    Measure/Link
    to MVP tip
    sheet

     

     

    Measure Description

    2.5% Rate
    Improvement
    Target

    5% Rate
    Improvement
    Target

    7.5% Rate
    Improvement
    Target

       

    Payment per
    improvement
    gap closed

    Payment per
    improvement gap closed

    Payment per
    improvement gap closed

    AIS

    Adult Immunization Status- Influenza

    $50

    $50

    $50

    BCS-E

    Breast Cancer Screening

    $125

    $175

    $300

    CBP

    Controlling Blood Pressure

    $200

    $250

    $375

    CCS

    Cervical Cancer Screening

    $125

    $175

    $300

    CHL

    Chlamydia Screening

    $125

    $175

    $300

    COL-E

    Colorectal Cancer Screening

    $125

    $175

    $300

    DSF

    Depression Screening and follow Up

    $50

    $50

    $50

    EED

    Diabetes Care – Eye Exam

    $125

    $175

    $300

    GSD

    Glycemic Status Diabetes

    $200

    $250

    $375

    KED

     

    Diabetic: Kidney Health Evaluation

    $125

    $175

    $300

    SNS-E

    Social Need Screening and Intervention 

    $50

    $50

    $50

  • HARP

    Measure/Link
    to MVP tip
    sheet

    Measure Description

    2.5% Rate
    Improvement
    Target

    5% Rate
    Improvement
    Target

    7.5% Rate
    Improvement
    Target

       

    Payment per
    improvement gap closed

    Payment per
    improvement gap closed

    Payment per
    improvement
    gap closed

    AIS

    Adult Immunization Status Influenza

    $50

    $125

    $125

    BCS-E

    Breast Cancer Screening

    $50

    $125

    $125

    CBP

    Controlling Blood Pressure

    $50

    $125

    $125

    CCS

    Cervical Cancer Screening

    $50

    $125

    $125

    EED

    Diabetes Care – Eye Exam

    $50

    $125

    $125

    GSD

    Glycemic Status Diabetes

    $50

    $125

    $125

    SPC

    Statin Therapy for Patients with CVD

    $50

    $125

    $125

  • Medicare

    Measure/Link
    to MVP tip
    sheet

    Measure Description

    2.5% Rate
    Improvement
    Target

    5% Rate
    Improvement
    Target

    7.5% Rate
    Improvement
    Target

       

    Payment per
    improvement
    gap closed

    Payment per
    improvement
    gap closed

    Payment per
    improvement
    gap closed

    BCS-E

    Breast Cancer Screening

    $100

    $200

    $500

    CBP

    Controlling Blood Pressure

    $100

    $200

    $500

    COL-E

    Colorectal Cancer Screening

    $100

    $200

    $500

    EED

    Diabetes Care – Eye Exam

    $100

    $200

    $500

    GSD

    Glycemic Status Diabetes

    $100

    $200

    $500

    KED

    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

    SPC

    Statin Therapy for Patients with Cardiovascular Disease

    $100

    $200

    $500

    SUPD

    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.