Updates to the Quality Plus Provider Program (QPP+)

Effective January 1, 2026, Select Health rolled out important enhancements to the Quality Plus Provider Program (QPP+), supporting our transition to proactive care and a more robust alternative payment model. Here’s what you need to know:

What's Changing?

• Measure Updates: Some measures have been removed. Each provider type will receive a specific schedule of measures in the updated agreement.
• Entry & Target Goal Thresholds: Clinics can earn additional compensation for meeting and exceeding gap closure goals, on top of per-gap closure rewards.
• Line-of-Business Separations: Measures are now separated into tables for each line of business (Medicare, Medicaid, Marketplace, and Commercial), ensuring alignment with member needs.
• Payment Schedule Frequency: Both measurement periods and payout dates will be slightly adjusted in 2026.
• Refocus on CMS Star Ratings: Updates emphasize CMS Star Ratings, central to driving value for Medicare Advantage members.

Why These Changes Matter

• Better Alignment: Programs now more closely match quality and proactive care goals.
• Recognition: High-performing clinics are rewarded for excellence.
• Tailored Measures: Program measures reflect the diverse needs of our member populations.
• Support for Star Ratings: Providers are empowered to achieve top CMS Star Ratings.