Incentive Programs

PIP webcast now available
A Partners in Performance (PIP) webcast is now available! The webcast is available within the Provider Manual at the URL below. It contains a section on using provider tools and resources, including details about how to enter data into Patient Profiles, as well as information about report options, timeframes and use of Filemart. We’re planning to use this new tool every year for the PIP program. We’d appreciate your feedback!

View the webcast. Remember, you must be logged in to view our performance program information.

Note - We’ve discovered an error in the narration for some measures. The narration indicates payment is per member per month when it is actually per member per measure. The only 2009 PIP measures that are paid per member per month are Tobacco Status and Advice and Recorded BMI Level.

PIP annual lab monitoring
A member in two or more drug classes within the measure will be represented as a separate denominator for each drug class.

For example, Jane Doe is on both an ACE and a diuretic and has had the appropriate lab (the same lab list applies to both drug classes). Jane Doe will be represented in the denominator twice — as if she were two separate members — and will also be in the numerator twice for meeting the lab requirements for both drug classes.

This means that, for purposes of calculating the payout, one member increases the denominator count to two in this case, creating a higher payout potential.

New Filemart lab result worksheet
If you’re not receiving the monthly PIP lab result worksheet for your diabetic members, please contact your PAE. This new report is similar to the blood pressure report and shows the last date of service and most current lab value received. Review all members on the report (including those showing “YES”) by focusing on the “Lab Result Info Message” column.

Percent Generic PIP measure
Please note that only members in HMO/POS are included in this measure.

Non-adherent member exclusion procedure
The Non-Adherent Member Exclusion Procedure was introduced as part of the PIP program in 2009. At the time of introduction, we omitted the Asthma Medication Management measure from the procedure specifications posted in the PIP technical manual and in the program brochure.

This was omitted in error. Exclusions are allowed for members that are not following physician recommendations for asthma care. Providers may submit non-adherent exclusion requests for these cases. We apologize for any inconvenience to your practice.