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Staywell 2021 Medicaid MMA Partnership for Quality (P4Q) Program Announcement

Date: 01/21/22

Fort Lauderdale, Florida

At Sunshine Health, we understand that the relationship between providers and members is essential to ensure superior healthcare for our members.

Prior to the October 1, 2021, integration of Staywell Health Plan and Sunshine Health, Staywell developed a 2021 P4Q Program to reward primary care providers (PCPs) who submitted documentation of current health status (ICD-10 codes) and HEDIS Measures (CPT, CPT II and NDC codes) by August 31, 2021.

As a result of the plans integrating, the P4Q Program ended August 31, 2021.  

Claims/encounters received by August 31, 2021, that contained all appropriate diagnostic and procedure codes are eligible for the program payment. A one-time program payment will be sent out during the first quarter of 2022.

These program measures pay $20:

  • Childhood Immunizations Combo 3 (CIS)
  • Diabetes HbA1c Control <8% (CDC)
  • Follow-Up After Emergency Department Visit for Substance Abuse - 7 Days (FUA)
  • Follow-Up After Emergency Department Visit for Mental Illness - 7 Days (FUM)
  • Immunizations for Adolescents Combo 2 (IMA)

These program measures pay $10:

  • Child and Adolescent Well-Care Visits (WCV) Ages 7-11
  • Well-Child Visits in the First 30 Months of Life (W30)  

If you have questions about our P4Q Program, please contact your Provider Relations Representative, Quality Practice Advisor or call Provider Services at 1-844-477-8313. The hours are Monday through Friday from 8 a.m. to 8 p.m. Eastern.