Updated 2024 PIP Manual now available

We recently updated our 2024 PCP Incentive Program (PIP) manual (login required).

To access the manual after logging into your account through the link provided, click PCP Incentive Program in the menu then click the Get the 2024 PIP Manual button. You can then bookmark the manual URL in your browser for quick access.

Here’s a summary of the changes:

Administrative details (pg. 9)

Under the Priority Health quality index scores definition, we clarified the description of the calculation for quality index scores (the word “plan” was missing from the last sentence in the first paragraph).

Submitting exclusions and more to our HEDIS team (pg. 11)

  • Bolded the statement that submitting documentation to HEDIS email inbox for PIP care gap closure should only be used as “when all other gap closure measures have been exhausted”
  • Added that the subject line of these email submissions should say “PIP Gaps in Care” to ensure timely processing

Appendix 2: Guidelines for reporting gap closure (pg. 34)

  • Added information on Electronic Clinical Data Systems (ECDS)
  • Added more detail to the audit findings section to align with the HEDIS Provider Reference Guide and the HEDIS ECDS Provider Guide

Appendix 5: Report inventory (pg. 41)

  • Added detail on the new ACN Measure Performance (PIP_003 TAB) report
  • Clarified that the PIP Gaps in Care Immunizations (PIP_011I TAB) report only includes members who are not meeting the incentivized immunization measures.