Common use of Provider Incentives Clause in Contracts

Provider Incentives. The MCO will conduct a pilot “gain sharing” program, subject to HHSC’s approval. The program will focus on collaborating with Network physicians and Hospitals in order to allow them to share a portion of the MCO’s savings resulting from reducing inappropriate utilization of services, including inappropriate admissions and readmissions. The program will include mechanisms whereby the MCO will provide incentive payments to Hospitals and physicians for quality care. The program will include quality metrics required for incentives, recruitment strategies of providers, and a proposed structure for payment.