Incentive Programs | McLaren Health Plan

McLaren Health Plan (MHP) is committed to providing high quality, cost-effective health care to our membership. By establishing a Primary Care Physician (PCP) Incentive Program, MHP builds a strong partnership with our contracted PCPs, resulting in improved access to health care services for our members.

To assist PCPs with achieving the quality goals of the NCQA 75th and 90th percentiles, MHP will provide you with monthly Gaps in Care reports beginning April 2025.

A Quick Reference Guide for the 2025 Pay for Transformation Program and incentive flyers documenting the requirements of each quality incentive are included for your review. MHP also has a HEDIS® Provider Manual at McLarenHealthPlan.org. The HEDIS Provider Manual explains each HEDIS measure in detail and the requirements for satisfying the measures.

Your Provider Relations Representative, and our Customer Service team can assist with any questions. Please call us at 888-327-0671 (TTY: 711).

Incentive Programs

Introduction

McLaren Health Plan (MHP) is committed to providing high quality, cost effective health care to our membership. By establishing a Pay for Transformation (P4T) program, MHP builds a strong partnership with our contracted Primary Care Providers (PCPs) which results in improved access and care coordination of health care services for our members. The P4T program provides incentives that optimize transformation activities, care coordination and quality by recognizing the outstanding efforts of our PCPs. The ultimate goal of the program is to improve health care outcomes.

For more details, see the PDF below.

McLaren Health Plan (MHP) is committed to providing high quality, cost-effective health care to our membership. By establishing a Primary Care Physician (PCP) Incentive Program, MHP builds a strong partnership with our contracted PCPs, resulting in improved access to health care services for our members.

The PCP Incentive Program, outlined below, provides incentives that optimize transformation activities, care coordination and quality by recognizing the outstanding efforts of our PCPS while improving health care outcomes.

For more details, see the PDF below.

The Adolescent Well Visit Incentive program is designed to reward and recognize McLaren Health Plan’s (MHP) Primary Care Providers (PCP) for excellent quality care.

In order to receive your incentive payment for each of your members ages 12-17, the member must be seen by Dec. 31 in the measurement year. You must have a minimum of 50 members per year.

For more details, see the PDF below.

This chlamydia screening program is designed to reward and recognize McLaren Health Plan’s (MHP) Primary Care Providers (PCP) who meet the requirement of performing/ ordering a chlamydia screening annually for female Medicaid members ages 16-24.

You will receive a $25 payment for each of your assigned MHP female Medicaid members ages 16-24 who receive a chlamydia screening.

For more details, see the PDF below.

This Diabetic Core Measures program is designed to reward and recognize McLaren Health Plan’s (MHP) Primary Care Providers who meet the HEDIS® requirement for completing diabetic core measures every year for MHP Medicaid members with diabetes, ages 18-75.

For each of your MHP Medicaid members with diabetes, ages 18-75, who receive recommended services as identified by the list above, you will receive a $50 payment. If their diabetes is appropriately controlled with an A1c below 8 and blood pressure below 140/90, you will receive an additional $25 for each controlled measure.

For more details, see the PDF below.

This incentive is for completion of Childhood Immunization Combo 10 by the Member's 2nd birthday and Adolescent Immunization Combo 2 by the Member's 13th birthday.

This healthy child immunization incentive is designed to reward and recognize our Primary Care Providers (PCPs). As an incentive for your participation in this program, MHP will reimburse you annually for each eligible MHP Medicaid member.

For more details, see the PDF below.

View All