Healthy Michigan Plan HRA form submission and incentive
When a member enrolls, they are asked to complete a brief state-issued health risk assessment (HRA) form with their PCP and identify annual healthy behavior goals.
Annually, in discussion with the member, primary care providers should assess the member's progress toward the healthy behavior goals and select a new goal for the upcoming year.
View/print a Healthy Michigan Plan Health Risk Assessment form:
The Michigan Department of Health and Human Services will accept the updated and the original versions of the Healthy Michigan Plan HRA through 2018.
- English:Healthy Michigan Plan Health Risk Assessment (updated Oct. 2018)
- Español: Examen de Riesgo de Salud y Instrucciones (updated Oct. 2018)
- Arabic: (updated Oct. 2018)
Completing the Healthy Michigan Plan HRA
- Schedule the annual visit
- Complete sections 1-3 before the annual visit
- Take the form to their annual visit with their PCP
The physician or mid-level primary care provider who conducts the visit should:
- Conduct an "annual visit" with the Healthy Michigan Plan member within the current measurement year (the visit must be greater than 11 months since that member's last HRA completion date.)
- Complete Healthy Michigan Health Risk Assessment with member during visit.
- Submit the competed HRA form within 60 days of the completed HRA date of service.
Submitting the HRA
You can submit the HRA in any one of three ways:
- Preferred: Enter HRA data directly into CHAMPS using the Health Risk Assessment Questionnaire web page - login required.
- Fax all pages of the completed HRA to Priority Health at 616.942.0616. (Members are not required to answer all of the member questions, but we must return all pages to the State.) Use the Healthy Michigan Plan HRA Fax Cover sheet for your convenience. Complete and return the form back to Priority Health within 10 days. Failure to complete the form properly will compromise the eligibility for the incentive.
- Fax completed forms directly to MDHHS at 517.763.0200. You can batch-fax all HRAs. We receive a weekly HRA data file to track completions.
Incentives for providers
Incentives: If a Healthy Michigan Plan Medicaid member is seen for an annual visit before they become a Priority Health member, you can bill the State for the annual visit but not for completing the HRA. Once that patient becomes a Priority Health member, then you can earn an incentive for submitting the HRA.
Priority Health awards providers a tiered incentive for successful submission of our members' Health Risk Assessment forms within the measurement year.
Incentive award will be included with all other year-end settlement payments in April.
The annual Health Risk Assessment (HRA) will only be paid out for the current measurement year only; it will not be paid out for subsequent years.
To be considered, HRA must be signed and include results of all questions and the provider attestation information. Handwritten forms must be legible. HRAs must be listed as "Completed" or "Completed - Waiting for Health Plan Review" in CHAMPS.