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2017 Physician Incentive Plan Reimbursement Rates

The Per Successful Patient (PSP) reimbursement rates and the Pharmacy Shared Savings target for the 2017 Physician Incentive Plan have been calculated.

The goal of the program is for PFK to make available a similar amount of potential incentive dollars to its community practices and physicians in 2017 as was available in 2016.

The following rates are modeled to achieve that goal.

Quality Measures – Per Successful Patient 2016 2017
Well Child Visits (15 month olds) $54.04 $49.89
Well Child Visits (3-6 year olds) $54.04 $49.89
Targeted Adolescent Well Care (AWC) Visits (12-18 year olds) $170.77 $180.60
Pharmacy Shared Savings Program 2016 2017
Per Member Per Month Target

  • Head lice medications
  • Topical acne medications
  • Otic antibiotics
  • Oral antibiotics
< $4.00 < $3.52

As a reminder, practices will be incentivized for each patient who completes one of the well checks listed above. Your practice will also receive 25 percent of the per member per month (PMPM) savings if the expense for the members attributed to your practice for the four medication classes listed above is less than the per member per month target. For prescribing formularies, please visit the Resource page.

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