Quality Incentive Program
The Quality Incentive Program (QIP) is designed for Medical/Surgical Hospitals for medical/surgical admissions. The program seeks to incentivize and reward quality around certain indicators as described later on this page. The QIP is based on best practices and standards of care, providers who participate in the program can expect to improve patient outcomes and receive financial incentives for doing so. The QIP is designed to promote collaboration between Empower and its providers in order to improve the quality of care provided to PASSE members.
There are five performance measures for Medical/Surgical facilities limited to medical/surgical admissions: post-discharge follow-up visit, prior authorizations, readmissions, patient satisfaction, and hospital-acquired conditions. Three measures are care measures, one measure is an efficiency and plan interface measure, and one is a satisfaction measure. The Medicaid South Central Region HEDIS averages are used for the care measures, while the Empower experience to date is used to establish a baseline for the PA and satisfaction measures.
The QIP does not include stand-alone psychiatric hospitals. Providers will receive data on a quarterly basis, and Empower will share the results of the QIP with individual providers. The program is based on best practices and standards of care, and providers will have access to data on their performance to help them improve. Empower is committed to working collaboratively with providers to improve the quality of care provided to PASSE members and looks forward to their participation in the QIP.
Primary Care Incentive Program
As part of our commitment to meeting the criteria set forth by the Arkansas Department of Human Services (DHS), Empower has developed and implemented a Primary Care Incentive Program to support rural and independent primary care physicians (PCPs).
To be eligible for the program, PCPs must meet certain criteria, including having an open panel and accepting Empower members for the entire year, being credentialed for Medicaid, having an email address on file, completing cultural competency training, and meeting contractual requirements for racial and language data.
The Primary Care Incentive Program is designed to incentivize PCPs for timely access and to encourage collaboration between Primary Care and Behavioral Health providers to improve members’ health and result in greater quality outcomes. The program focuses on five key performance measures that have been taken from nationally recognized health care organizations.
The measures include:
- The maintenance oversight of ADHD medication for members 6-19 years old on the medication for greater than 30 days
- Children’s access to primary care practitioners
- Well-child and adolescent care visits
- Flu vaccinations
- Appropriate medication regimens for asthma.
Empower solicited feedback from independent providers in rural and urban areas of the state, the Arkansas Medical Society and the Arkansas Chapter of the American Academy of Pediatrics to assist in the development of appropriate quality measures.
These measures are reported and evaluated frequently and reported to the Board of Managers for improvements in outcomes. Also, the incentive programs are evaluated for expansion or revision for the purpose of improving members services and care.
Quality Incentive Program
The Quality Incentive Program (QIP) is designed to incentivize and reward quality around certain indicators as described later on this page. The QIPs are based on best practices and standards of care, providers who participate in the program can expect to improve patient outcomes and receive financial incentives for doing so. The QIP is designed to promote collaboration between Empower and its providers in order to improve the quality of care provided to PASSE members.
There are quality performance measures limited to The Medicaid South Central Region HEDIS averages are used for the care measures, while the Empower experience to date is used to establish a baseline for the satisfaction measures.
The program is based on best practices and standards of care, and providers will have access to data on their performance to help them improve. Empower is committed to working collaboratively with providers to improve the quality of care provided to PASSE members and looks forward to their participation in the QIP.
These measures are reported and evaluated frequently and reported to the Board of Managers for improvements in outcomes. Also, the incentive programs are evaluated by the state for expansion or revision for the purpose of improving members services and care.