The Pay for Performance Program
The Meridian Medicaid Plan (Meridian) Pay for Performance (P4P) program rewards contracted partners in care for delivering quality preventive services such as cancer screenings, immunizations, and well-child visits to members.
For 2026, there are three P4P incentive target levels for Meridian Primary Care providers. We will continue to reward other providers like OB/GYNs and behavioral health providers, who offer essential services for key measures.
Updates for 2026
- There are more Child and Adolescent Well-Care Visits (WCV) incentive categories to better represent childhood development
- Many healthcare services can be completed via telehealth. See measures noted with a star ★
Please contact your Meridian Quality Practice Advisor, Associate Quality Practice Advisor, your Provider Relations representative at ILProviderRelations@mhplan.com or, Provider Services at 866-606-3700 with questions.
Access updated program information quickly via the Meridian secure provider portal. After logging in, view updated performance data, target percentile status, and payments earned year to date.
Primary Care Provider (PCP) Incentives*
Measure Abbreviation | Measure Name | Target 1 (50th Percentile) | Payment 1 | Target 2 (75th Percentile) | Payment 2 | Target 3 (90th Percentile) | Payment 3 |
|---|---|---|---|---|---|---|---|
★ AAP | Adults' Access to Care – Total | 78% | $5 | 83% | $20 | 86% | $30 |
BCS | Breast Cancer Screening | 56% | $20 | 61% | $40 | 66% | $60 |
★ CBP | Controlling High Blood Pressure | 68% | $10 | 71% | $20 | 75% | $40 |
CCS | Cervical Cancer Screening | 58% | $15 | 62% | $40 | 68% | $60 |
CHL | Chlamydia Screening in Women – Total | 56% | $10 | 65% | $20 | 71% | $40 |
CIS – Combo 10 | Childhood Immunization Status – Combination 10 | 28% | $15 | 33% | $50 | 40% | $100 |
CIS – Flu | Childhood Immunization Status - Influenza (2 shots) | 35% | $5 | 42% | $10 | 49% | $20 |
GSD | Glycemic Status Assessment for Patients with Diabetes – HbA1c Control (<8%) | 61% | $15 | 65% | $30 | 68% | $50 |
IMA – Combo 2 | Immunizations for Adolescents – Combination 2 | 37% | $10 | 44% | $20 | 52% | $40 |
WCV | Child and Adolescent Well-Care Visits – Ages 3 - 11 | 62% | $10 | 68% | $20 | 73% | $40 |
WCV | Child and Adolescent Well-Care Visits – Ages 12 - 17 | 55% | $10 | 61% | $20 | 67% | $40 |
WCV | Child and Adolescent Well-Care Visits – Ages 18 - 21 | 32% | $10 | 38% | $20 | 46% | $40 |
OED | Oral Evaluation, Dental Services – Ages 0-2 | 18% | $15 | 26% | $30 | 31% | $50 |
Incentives for Rendering Providers. Rendering provider may be PCPs or OB/GYNs**
Measure Abbreviation | Measure Name | Payment | Target |
|---|---|---|---|
★ PPC | Prenatal and Postpartum Care – Timeliness of Prenatal Care | $50 | Must be completed in the first trimester, no target to meet |
Prenatal and Postpartum Care – Postpartum Care | $50 | Must be completed within 7 to 84 days after delivery, no target to meet |
Rendering provider may be PCP, Behavioral Health, or another qualified provider
Measure Abbreviation | Measure Name | Payment/Target |
|---|---|---|
★ FUH – 7 | Follow-up After Mental Health Hospitalization 7 day | $50 per compliant visit, no target to meet |
Incentives are paid after completion of qualifying services in compliance with 2026 HEDIS® guidelines. A complete list of covered codes is in the HEDIS Quick Reference Guide on the Meridian website.
★ Indicates a measure can be completed via a telehealth visit
*Incentives are paid to the Primary Care Provider (PCP) at the provider TIN level. Payments will be made for Q1/Q2 2026, Q3 2026, and final 2026 performance throughout 2026 and 2027.
** Incentives are paid to the provider who rendered the service at the provider TIN level. Claims must be submitted by 12/31/2026. Payment will be made in Q1 2027.
Meridian maintains the right to modify or discontinue the P4P program and will notify providers of changes or program alterations.