CountyCare - Pay-for-Performance Program

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Coronavirus Information For Members and For Providers

Pay-for-Performance Program

CountyCare is pleased to offer primary care providers a new pay-for-performance program for HEDIS Year 2020/Calendar Year 2019. The new program complements the revised primary care provider policy. The goal of the program is to offer a simple and focused, yet rewarding bonus structure for high quality performance.

The below documents provide a list of the P4P measures and compliant codes and describe the mechanism through which performance will be evaluated and final payments calculated.

The population health tool, Vision, may be utilized to identify members with gaps in care or who need services captured by HEDIS measures. CountyCare providers are expected to provide high quality care, follow practice guidelines posted on CountyCare’s website, and promote member self-management through getting needed care. In addition, care provided this calendar year will often support next year’s HEDIS measure compliance, as measurement follows clinically appropriate look back periods.

If you have any questions, please reach out to your Provider Relations representative or call Provider Relations at (312) 864-8200.