Results & Recognition Program
Improving care can make a meaningful difference in your patients’ health and wellness — and can improve your HEDIS scores. As you treat Medicaid, Medicare and/or FIDE-SNP members, we want to work closely with you to improve clinical quality outcomes and reward you for closing gaps in care through our Results & Recognition (R&R) Program.
To join a R&R Program and receive incentive payments, you must complete one of the following contact forms for the applicable program.
- Primary Care Provider – routine screenings and checkups
- Endocrinology – diabetic preventive screenings and services
- Women’s Health or OB/GYN – prenatal and postpartum care
- Ophthalmology – dilated/retinal eye exams for members with diabetes
- Cardiology – cardiovascular-related preventive screenings and services
This form confirms your voluntary commitment to work with us to improve quality and receive incentives for reaching the targeted benchmarks. For more information on the R&R programs, please review the resources below:
- HEDIS and Quality Management Program Manual
- Women’s Health R&R Program Manual
- Supplemental Data for Gap Closure Guide
Results & Recognition Programs Overview
Each practice in the Results & Recognition program receives:
CLINICAL QUALITY IMPROVEMENT LIAISON
- A dedicated clinical liaison as a single point of contact on quality
- Provides a comprehensive overview of the R&R programs for all LOBs
- Provides education, support and resources
- Assist to promote and achieve shared savings and incentives through improved quality performance and practice transformation
RESOURCES
- Monthly Performance and Patient Level Gap Reporting
- Educational Webinars
- Provider Billing Tips for Optimizing HEDIS Results
- Suggested Best Practices
INCENTIVES
- Additional payments for quality gaps closed for selected HEDIS measures
- Incenvitives as noted below:
- Medicaid quality performance gap closed over the NCQA percentile targets
- FIDE-SNP quality performance gap closed once identified Stars rating reached
- Medicare quality performance gap closed once identified Stars rating reached