The 2024 Pay for Performance Program
The Meridian Medicaid Plan (Meridian) Pay for Performance (P4P) Program (PDF) is a pay-for-performance incentive program for our contracted providers. We reward our partners in care for delivering quality preventive healthcare services such as cancer screenings, immunizations, and well-child visits to members.
The following grid is a quick reference to the 2024 Meridian P4P incentives for Primary Care Providers (PCPs). Please contact your Meridian Provider Relations Representative at ILProviderRelations@mhplan.com or our Provider Services Department at 866-606-3700 with questions. PCPs can also login to the secure provider portal to view updated performance data, target percentile status, and payments earned year to date.
Incentives are paid after completion of all qualifying services in compliance with HEDIS® 2024 guidelines. A complete list of covered codes for these measures can be found within the HEDIS Quick Reference Guide 2024 (PDF) on the Meridian website. The incentive is paid to the Primary Care Provider at the Provider TIN level. Meridian maintains the right to modify or discontinue the P4P Program and will notify providers of any changes or incentive program alterations.
Measure Abbreviation | Measure Name | Target 1 | Payment 1 | Target 2 | Payment 2 |
|---|---|---|---|---|---|
AAP | Adults' Access to Care – Total | 79.00% | $10.00 | 83.00% | $20.00 |
BCS | Breast Cancer Screening | 58.00% | $20.00 | 63.00% | $40.00 |
CBP | Controlling High Blood Pressure | 68.00% | $20.00 | 73.00% | $40.00 |
CCS | Cervical Cancer Screening | 58.00% | $20.00 | 61.80% | $40.00 |
CHL | Chlamydia Screening in Women – Total | 63.00% | $20.00 | 68.00% | $40.00 |
CIS – Combo 10 | Childhood Immunization Status – Combination 10 | 38.00% | $20.00 | 46.00% | $40.00 |
HBD | Hemoglobin A1c Control for Patients with Diabetes – HbA1c Control (<8%) | 58.00% | $20.00 | 61.00% | $40.00 |
IMA – Combo 2 | Immunizations for Adolescents – Combination 2 | 41.00% | $20.00 | 49.00% | $40.00 |
PPC | Prenatal and Postpartum Care – Timeliness of Prenatal Care | First trimester diagnosis code = $40.00 First trimester diagnosis code + SDOH diagnosis code = $50.00 | |||
Prenatal and Postpartum Care – Postpartum Care | Postpartum visit code = $40.00 Postpartum visit code + SDOH diagnosis code = $50.00 | ||||
WCV | Child and Adolescent Well-Care Visits | 56.00% | $10.00 | 62.00% | $20.00 |