Medicare Advantage Intermediate Physician Incentive program
The Medicare Advantage Intermediate Physician Incentive (MA-IPi) program rewards you for helping your patients who are UnitedHealthcare® Medicare Advantage members get the quality care they need. These patients are also referred to as MA-IPi Customers.
When you participate in the program, you can earn quarterly and annual bonuses for addressing care opportunities for these patients. In 2025, you can also earn additional bonuses for meeting and/or exceeding a quality target for each measure.
We determine the bonuses based on our review of feedback from health care professionals like you, as well as Star Rating measures from the Centers for Medicare & Medicaid Services (CMS).
2024 MA-IPi information and dates
If there is a conflict between this page and the Terms and Conditions, the MA-IPi Terms and Conditions control.
2025 incentive opportunities
Quality Care Bonuses
We’ll reward you when your patients who are Medicare Advantage members receive Annual Care Visits, preventive screenings and medication management. You can earn the Quality Target Bonus in addition to the Quality Care Bonus, up to $475 per patient.
| Quality Care Measure1 | Quality Care Bonus per member per activity | Quality Performance Target | Quality Target Bonus for meeting and/or exceeding the Quality Target |
|---|---|---|---|
| Annual Care Visit (ACV) Dates of service: Jan. 1–June 30, 2025 |
$50 | Not eligible | Not eligible |
| Annual Care Visit (ACV) Dates of service: July 1–Dec. 31, 2025 |
$25 | Not eligible | Not eligible |
| Breast Cancer Screening (BCS-E) | $10 | 77% | $20 |
| Controlling High Blood Pressure (CBP)2 | $10 | 83% | $20 |
| Glycemic Status Assessment for Patients With Diabetes (GSD) 2 | $10 | 88% | $20 |
| Kidney Health Evaluation for Patients With Diabetes (KED) | $10 | 61% | $20 |
| Medication Adherence for Cholesterol (MAC)2 | $15 | 90% | $30 |
| Medication Adherence for Diabetes Medications (MAD)2 | $15 | 88% | $30 |
| Medication Adherence for Hypertension (RAS Antagonists) (MAH)2 |
$15 | 91% | $30 |
| Osteoporosis Management in Women Who Had a Fracture (OMW) | $10 | 53% | $50 |
| Statin Therapy for Patients With Cardiovascular Disease (SPC) | $10 | 88% | $30 |
| Statin Use in Persons With Diabetes (SUPD) | $10 | 90% | $30 |
| Transitions of Care TRCMRP – Medication Reconciliation Post-Discharge | $10 | 75% | $20 |
Suspect Medical Condition Assessment Bonus
Your practice can earn a quarterly bonus when you assess eligible Medicare Advantage members for suspect medical conditions. Eligible patients and medical conditions are identified in the Patient Care Opportunity Report (PCOR) and Practice Assist. Practice Assist is also used to document the results of your assessment.
Here’s how it works:
- Earn $15 for each documented suspect medical condition that you’ve assessed and diagnosed, or assessed but were unable to diagnose
- If you diagnose a suspect medical condition, include the appropriate ICD-10 code(s) when you submit the claim
- If you assess but are unable to diagnose the condition, report in Practice Assist that you’re unable to diagnose the suspect condition at the present time. Be sure to include the date of the assessment.
Eligibility
Each year, we invite eligible primary care physicians to enroll in the program. You'll receive an invitation to participate by mail that details the current year's bonus opportunities and criteria.
Track your progress
You can use Practice Assist to monitor your progress toward these incentive opportunities. It’s available in the UnitedHealthcare Provider Portal in the Clinical & Pharmacy dropdown menu. To access the portal, click Sign In in the upper-right corner of this page.
Payout dates
| Dates of service | Payment date3 | Payment eligibility |
|---|---|---|
| Jan. 1–March 31, 2025 | July 31, 2025 | Quarterly |
| April 1–June 30, 2025 | Oct. 31, 2025 | Quarterly |
| July 1–Sept. 30, 2025 | Jan. 31, 2026 | Quarterly |
| Oct. 1–Dec. 31, 2025 | May 31, 2026 | Quarterly |
| Jan. 1–Dec. 31, 2025 | May 31, 2026 | Annual |
Resources
- Prioritize which patients should come in for a visit by accessing your PCOR or Practice Assist
- PCOR shows which patients are due for preventive care including screenings, annual care visits or other exams
- Encourage your patients to come in for a visit and schedule their next appointment before they leave
- Ask patients to provide information about their current specialists, prescription medications and exercise level prior to their visit
- Complete a health risk assessment (HRA) during annual wellness visits
- HRAs help identify barriers to health care such as Social Drivers of Health (SDoH) that include housing, transportation, food insecurity, family circumstances and social support
- Document all SDoH ICD-10 Z codes. Access our Social drivers of health Z-code provider guide.
Questions?
If you have questions, please contact your UnitedHealthcare representative or practice performance manager. For additional support, visit our Contact us page.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
1The information in these columns is subject to change at CMS’ discretion. If CMS retires a HEDIS Quality Care Measure or moves it to “display status,” United reserves the right to remove it from this bonus opportunity. With the exception of TRCMRP, compensation for care measure closures will be limited to a single compliant closure per member per year.
2CBP, GSD, MAC, MAD and MAH are eligible for payment annually only. All other measures are paid out quarterly.
3To ensure that the provider is reimbursed as outlined above, we’ll review the provider’s claims and data submissions for the previous quarter(s) and make additional payments, if applicable.