Introducing the Enhanced Provider Pay-for-Performance Program
At Gateway Health, we value the important role practitioners play in serving our members. We support recognizing and rewarding performance for those practices committed to providing quality healthcare that is accessible and efficient. Therefore, working collaboratively with an advisory work group of network primary care practitioners, (MD, DO, NP and DDS) Gateway would like to welcome you to the enhanced Gateway to Practitioner Excellence® Program. This program supports Gateway’s mission to improve the health and wellness of the individuals and the communities we serve by providing access to integrated, superior health care.
- Providers must opt-in to the program to be eligible for payments.
- Providers must meet the minimum membership requirements noted in the Who Is Eligible For The Program section below.
- Each measure requires the entity to have a minimum of 10 members in the denominator to qualify to be scored.
- Following the completion of the 2020 GPE Program, eligible providers will receive two payments. Payment one will be in February 2021 and will be for claims paid through December 31, 2020. The second and final true-up payment will be calculated in May 2021.
- Payments can be earned through benchmarks (Medicaid), Stars ratings (Medicare), or percent improvement (Medicaid/Medicare).
If you have any questions about the Gateway to Practitioner Excellence® pay-for-performance program, please contact your Gateway Health Clinical Transformation Consultant or your Provider Account Liaison.