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A Message from Dr. McGill on the P4P Program


P4P Program FAQs

The Prepayment Program is the P4P program for 2020, where all Providers are being paid for the P4P program prior to the end of year.

The P4P program pays Providers as HEDIS gaps are closed in the measurement year and the Prepayment program is paying Providers in advance for those same measures closed in 2019.

The P4P prepayment is calculated based on the Provider’s 2019 HEDIS incentive performance. Each measure has a specific incentive amount that is paid after a target score is achieved. The 25% increase for 2020 is a 25% increase in payment, it is not based on increasing the provider’s score by 25% and then calculating the payment.

The P4P prepayment can enhance quality of care by incentivizing PCPs to focus on preventive and screening services. IlliniCare Health is excited to set up SDS feeds which automate reporting and increase performance and related incentives. We also request access to your system’s EMR for medical records auditing purposes.

IlliniCare Health will not facilitate a reconciliation.

The 2020 P4P program is a one-time payout program being offered for the entire 2021 reporting year.

Please reach out to IlliniCare Health’s Quality Improvement department at 833-216-7278.

IlliniCare Health will continue to provide quality improvement, provider relations, pharmacy, contracting, community outreach and care management services to all providers and members.