Commercial Quality Incentive Program

The following guidelines apply to our Commercial Quality Incentive Program (CQIP); participation in the program is voluntary. (Note: Our CQIP program will now require you to opt-in. To do this, you must sign in to the Care Gap Management Application (CGMA) by October 1, 2024, and indicate that you wish to participate in the 2024 program. Once you have opted in, you will be opted into all QIP programs you are eligible for.)

We continue to collaborate with our contracted PCPs through our Commercial QIP, which offers financial incentives to reward providers who address Quality Rating System (QRS) gaps in patient care, resulting in improved health outcomes for our Individual on-exchange members. The QRS measures are used by the Centers for Medicare & Medicaid Services (CMS) to determine Star ratings for qualified health plans (QHPs). These Star ratings are designed to assist consumers who are selecting QHPs through an exchange.

See the tabs below for information about:

• Eligibility and payout
• Member attribution
• QRS gap closure

• Medicare QIP gap closure

The following tabbed guidelines apply to our 2024 Commercial Quality Incentive Program (CQIP).