Provider Network/ Providers/ Incentive Programs
Search programs...

Incentive Programs

Manage provider performance-based incentive programs, track progress, and process payments

Quality Bonus Program
Period: Q1 2026  ·  Active
Target MetricHEDIS Composite ≥80%
Current Performance78.2%
97.75% toward target
Budget: $250,000 Earned to date: $152,400
Cost Efficiency Program
Period: Q1 2026  ·  Active
Target MetricPMPM ≤$420
Current Performance$412 PMPM
Target Achieved — 101.9%
Budget: $180,000 Earned to date: $180,000
Patient Satisfaction Program
Period: Q1 2026  ·  Active
Target MetricCAHPS ≥4.5 stars
Current Performance4.2 stars
93.3% toward target
Budget: $120,000 Earned to date: $78,600
Provider Performance vs Targets
Provider Program Metric Target Actual % Achieved Est. Payment
Dr. Amelia ChenQuality BonusHEDIS Composite80%84.2%
105.3%
 $8,400
Dr. Robert PatelQuality BonusHEDIS Composite80%79.1%
98.9%
 $0
Dr. Sandra KimCost EfficiencyPMPM$420$408
102.9%
 $5,200
Dr. Marcus WilliamsCost EfficiencyPMPM$420$435
96.6%
 $0
Dr. Carlos RiveraPatient SatisfactionCAHPS Stars4.54.6
102.2%
 $4,800
Riverside Medical GroupQuality BonusHEDIS Composite80%82.7%
103.4%
 $22,100
Dr. Laura NguyenPatient SatisfactionCAHPS Stars4.54.1
91.1%
 $0

Payment History — 2025

Q1 2025
$187,240
Paid to 34 providers  ·  Paid
Q2 2025
$203,810
Paid to 37 providers  ·  Paid
Q3 2025
$218,600
Paid to 39 providers  ·  Paid
Q4 2025
$241,350
Paid to 41 providers  ·  Paid
Total 2025 Incentive Payments
$851,000
Page Guide — Incentive Programs
Overview
Provider incentive programs reward high performance in quality, cost efficiency, and patient satisfaction. Programs are funded from the shared savings pool and paid quarterly.
  • Program cards show live progress toward current-period targets
  • Use "Create Program" to add new incentive programs
  • Payments are processed automatically after period close
Progress Tracking
Progress bars update monthly when claims and quality data are ingested. ≥100% means the provider has met or exceeded the target for the period and is eligible for full bonus payment. Partial achievement may earn partial payment depending on program design.
Payment Eligibility
  • Target must be met by period end date
  • Provider must have active contract in good standing
  • Minimum panel size requirements must be met
  • Claims submission timeliness standard: ≥90% within 90 days
Creating Programs
Click "Create Program" to define a new incentive program. You'll need: program name, target metric, measurement period, eligible provider set, budget amount, and payout structure (all-or-nothing or tiered). Programs require Medical Director and Finance approval before activation.