Updated Process and Timelines: PCP Value-Based Contract Participation

Updated Process and Timelines: PCP Value-Based Contract Participation

September 29th, 2023 | Network News

At the September 13th Practice Manager’s Meeting, we discussed the importance of notifying AHP when providers join and leave practices as soon as possible. Timely notification ensures that primary care providers are placed on contract within the soonest roster submission window and begin to earn clinical integration dollars for their attributed population as soon as possible.

The following dates will determine a PCP provider’s contract inclusion, starting with the 2024 roster submissions. For new providers submitted to AHP:

  • By October 14, 2023: The provider’s participation for the Excellus, MVP, and Monroe Plan contracts begins on January 1, 2024.
  • Between October 15, 2023, and May 14, 2024: The provider will join MVP value-based contracts beginning on July 1, 2024, while Excellus and Monroe Plan participation will commence on January 1, 2025.
  • Between May 15, 2024, and October 14, 2024: The provider will join Excellus, MVP, and Monroe Plan contracts beginning on January 1, 2025.

Physicians are eligible for the PCP Reward Plan in the year their Excellus contract participation begins, while primary care APPs become Reward Plan eligible when they have sufficient contract attribution to become fully enrolled.

It is equally important for AHP to be informed of providers leaving practices, including the effective date of their termination and the reason (e.g., retired, moved out of the area). For providers leaving to work in other practices, any information about their new employer is helpful. This information is used to determine if the practice will retain the departing provider’s attribution and related clinical integration dollars.

Sharee Turpin, AHP’s Provider Data and Communications Coordinator, has established processes with large practices and systems to collect provider updates on a regular cadence.  Independent practices should contact Jana Darlington with updates relative to their provider rosters as soon as possible. If you have any questions, please contact Jana Darlington.