Physician Performance Based Compensation

Know Where You Stand with Our PCOR, PCMH, PCPi and QPIP Reports

UnitedHealthcare is committed to providing physicians with actionable, patient-specific information that will help them deliver the best possible clinical care while empowering them to meet personal and professional goals through our Physician Performance Based Compensation Program (PPBC).

This program includes the Patient Care Opportunity Reports (PCOR), the Patient-Centered Medical Home Program (PCMH), the Primary Care Physician Incentive Program (PCPi) and Quality Provider Incentive Program (QPIP).

The Patient Care Opportunity Report (PCOR) provides clear and actionable information for physician groups and organizations to use to identify their patients’ adherence to preventive screenings, treatments and medications.

Medicare Advantage PCOR

The UnitedHealthcare Medicare Advantage PCOR shows which of our members are due for preventive care including screenings, well care visits or other exams. The information is based on claims and pharmacy records, and can help you close care opportunities, including those related to pharmacy compliance, tied to Healthcare Effectiveness and Data Information Set® (HEDIS) measures and Centers for Medicare & Medicaid Services (CMS) guidelines.

View the Medicare Advantage PCOR Overview.

First Time Accessing a PCOR Report?

If this is your first time accessing your report, please use your PIN to log in. If you don’t know your PIN, please contact your UnitedHealthcare Network Account Manager or your Provider Advocate.

The same PIN works for the Medicare Advantage and Commercial and Exchange reports.

The Patient-Centered Medical Home Program (PCMH) is one of the UnitedHealthcare performance based contracting programs offered in specific markets. The PCMH program provides enhanced payments for primary care providers that implement the medical home model of care.

For questions on your payment, please contact Vishal Rajwani at vishal.rajwani@uhc.com

The Commercial Plan Primary Care Professional Incentive (PCPi) program offers care providers an opportunity to earn bonuses for encouraging their patients who are UnitedHealthcare Commercial members to take an active role in their preventive care and choose treatment options with lower out-of-pocket costs.

In 2017 the PCPi Program will be offered to a limited number of practices in Arkansas, Florida, Georgia, Missouri, and Texas. In 2018, we plan to review additional practices and markets for inclusion in the program.

PCPi Program Management Report

To help you achieve your target measures and earn a bonus payment, we created a management report of your performance in the program related to cost-efficiency and quality metrics. You will be asked to enter the PIN provided to you at the start of the program. If you need this PIN please send an e-mail to PCPi_EI@UHC.com.

Patient-Centered Primary Care Collaborative (PCPCC) is a great resource for finding both general information about the principles and value of the medical home as well as specific guides for different stakeholders.

National Committee for Quality Assurance (NCQA) is a resource for recognition programs including a program for medical home recognition.

Name of program:

Quality-Based Physician Incentive Program (QPIP) & Quality-Based Shared Savings Program (QSSP)

Description of the programs:

Quality-Based Physician Incentive Program (QPIP) & Quality-Based Shared Savings Program (QSSP)

The Quality-Based Physician Incentive Program (QPIP) provides physicians the opportunity to earn an incentive payment by performing clinically appropriate procedures at designated facilities and meeting certain quality metrics.

The Quality-Based Shared Savings Program (QSSP) provides physicians in California the opportunity to join other care providers and share a quarterly distribution for savings earned by performing clinically appropriate procedures at designated facilities and meeting certain quality metrics.

First Time Accessing a QPIP/QSSP Report?

If this is your first time accessing your report, please use your PIN to log in. If you don’t know your PIN, please email the QPIP/QSSP team at west_lab_inquiry@uhc.com.

Need Help with Your Reports?

If you have any questions about the UnitedHealthcare Provider report package or the QPIP/QSSP program or assistance in accessing reports, please contact QPIP/QSSP team at west_lab_inquiry@uhc.com.

Need Help with Your Reports?

If you have any questions about the UnitedHealthcare Physician Performance Based Compensation program or need additional information, please contact your Network Management Contract Representative or Provider Advocate.

For questions about Link or accessing your reports in the Document Vault through Link, please contact:

UnitedHealthcare Web Support
Phone: 866-842-3278, option 1
Monday - Friday from 7 a.m. to 9 p.m. Central Time