| Per-unit quality incentives for service provision | Money per person for completing testing or services recommended, eg, $10 per member for each health plan member who has diabetes and has annual eye exam | Patients may not participate in services for reasons unrelated to the primary care physician or the care management services are not effective in encouraging this participation Requires ability to capture population-based data and report Only some insurers do this
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| Per-unit quality incentives for meeting clinical benchmarks | Money per person for meeting clinical benchmarks, eg, $50 per member for each health plan member who has blood pressure <140/80 at last physician visit of the year | Requires patient to make health behavior changes, and they may be unable or unwilling to do so or the care management services may be ineffective in encouraging these changes Requires ability to capture population-based data and report Only some insurers do this
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| Patient-centered medical home designation | 10% uplift in evaluation and management billing for all services if designated | Only occurs yearly Designation line conveys “in” or “out” of designation and difficult to attribute to care management services only to meet designation Requires up-front investment Only one insurer pays for this at present
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