Different Incentive Payments for Different PCMH Designations

August 30, 2016

Shared by: Michigan Primary Care Consortium



  • Known issue with Meridian Health Plan and United Healthcare Community Plan

  • MPCC seeks to be an objective facilitator for discussion between health plans, PO/PHOs, and MDHHS

  • Rodger Prong at Oakland Physician Network Services is helping PO/PHOs share their perspective

  • Kathy Stiffler at MDHHS is open to further conversation and shared a crosswalk of all PCMH certification/accreditation/recognition standards with the Medicaid Health Plan (MHP) Medical Directors on 8/17/16.

  • MDHHS also expressed initial willingness to help facilitate the conversation but made clear that it is outside of their role to intervene regarding the manner in which health plans contract with their provider network on incentives. This is not a contract compliance issue since the contract does not/should not specify how MHPs pay/incentivize their contracted providers.










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