Common use of Provider Incentives Clause in Contracts

Provider Incentives. (2 pages, plus 1 additional page per additional MCO Program bid if the Respondent’s response differs by MCO Program) The Respondent must submit a proposal for a pilot “gain sharing” program. The program should focus on collaborating with Network physicians and Hospitals in order to allow them to share a portion of the Respondent’s savings resulting from reducing inappropriate utilization of services, including inappropriate admissions and readmissions. The proposal should include mechanisms whereby the Respondent will provide incentive payments to Hospitals and physicians for quality care. The proposal should include quality metrics required for incentives, recruitment strategies of providers, and a proposed structure for payment.