New Ambetter specialist incentive program

Date: 08/05/22

Fort Lauderdale, Florida

Ambetter from Sunshine Health is pleased to announce our new Specialist instance for the Continuity of Care (CoC) program. The program is designed to reward providers who help members obtain preventive care, manage their chronic conditions and monitor their health.

The program combines Appointment Agendas, HEDIS measures and pharmacy metrics. Providers are eligible for rewards when they conduct proactive outreach to members with chronic conditions. The goal is to get members to see their specialists more often to improve the quality and frequency of care and consultations needed to manage and treat their medical conditions.

Providers are eligible for a $300 bonus each time a member completes a verified or documented Appointment Agenda to address a chronic health condition. Bonuses can be earned when providers ensure members update their health histories and take their prescribed medications. The CoC program is being added in addition to our Health Plan’s other provider bonus programs, which will not be affected.

Read the Ambetter 2022 Specialist Continuity of Care Program (PDF) guide to learn more about the program, including the eligibility rules and how to submit documentation to earn the bonuses.