In the 2026 MA-PCPi program, quarterly and annual Quality Care bonuses are available to you. To earn, address the following open Standard Quality Care Measures and Key Care Opportunities for your patients who are UnitedHealthcare® Medicare Advantage members. Key Care Opportunities identify specific quality care gaps for your members in need of recommended screenings, follow-ups, preventative care and medication management.
| Quality Care Measure name | Standard Eligible Payment per Care Measure Closure | Key Care Opportunity Payment per Care Measure Closure |
|---|---|---|
| Osteoporosis Management in Women Who Had a Fracture (OMW) | $100 | $250 |
| Statin Use in Persons with Diabetes (SUPD) | $20 | $250 |
| Breast Cancer Screening (BCS-E) | $10 | $250 |
| Eye Exam for Patients with Diabetes (EED) | $10 | $250 |
| Colorectal Cancer Screening (COL-E) | $10 | $150 |
| Kidney Health Evaluation for Patients with Diabetes (KED) | $10 | $150 |
| Controlling High Blood Pressure (CBP)3 | N/A | $150 |
| Glycemic Status Assessment for Patients with Diabetes (GSD)3 | N/A | $150 |
| Medication Adherence for Cholesterol (Statins) (MAC) 3 | N/A | $150 |
| Medication Adherence for Diabetes Medications (MAD) 3 | N/A | $150 |
| Medication Adherence for Hypertension (RAS antagonists) (MAH) 3 | N/A | $150 |
| Key Care Annual Care Visit (Key Care ACV) | N/A | $100 |
| Fall Risk Management (FRM) | N/A | $20 |
| Management of Urinary Incontinence in Older Adults (MUI) | N/A | $20 |
| Follow-up after Emergency Department Visit for Patients with Multiple Chronic Conditions (FMC)2 | $25 | N/A |
| Medication Reconciliation Post-Discharge (MRP)2 | $25 | N/A |
You can earn a Complete Care Bonus of $100 for any MA-PCPi member, who has at least one Key Care Opportunity, when you address 100% eligible measures outlined in the following table:
| Quality Care Measure Name |
|---|
| Breast Cancer Screening (BCS-E) |
| Colorectal Cancer Screening (COL-E) |
| Osteoporosis Management in Women Who Had a Fracture (OMW) |
| Eye Exam for Patients with Diabetes (EED) |
| Glycemic Status Assessment for Patients with Diabetes (GSD)3 |
| Kidney Health Evaluation for Patients with Diabetes (KED) |
| Controlling High Blood Pressure (CBP)3 |
| Medication Adherence for Diabetes Medications (MAD)3 |
| Medication Adherence for Hypertension (RAS antagonists) (MAH)3 |
| Medication Adherence for Cholesterol (Statins) (MAC)3 |
| Statin Use in Persons with Diabetes (SUPD) |
If there is a conflict between this document and the Terms and Conditions, the MA-PCPi Terms and Conditions control.
1 To help ensure we reimburse you as outlined, we'll review the provider's claims and data submissions for the previous quarter(s) and make additional payments, if applicable.
2 With the exception of MRP and FMC, compensation for care measure closures will be limited to a single compliant closure per member per year.
3 These measures will be paid out at the end of the year based on their final compliance result.
4 We’ll review claims and data submissions for the previous quarter(s) and make additional payments, if applicable.
5 Bonuses for Key Care Opportunities are in addition to the eligible payment per Standard Quality Care Measure closure for all members.