The Medicaid Managed Care Quality Incentive Program (QIP) provides critical support
to improve health care in underserved communities.
The mainstream Medicaid Managed Care Quality Incentive Program is essential for addressing the healthcare gaps that have persisted for far too long across New York State. The program helps to ensure that communities that often have the highest rates of chronic disease and health challenges receive the resources they need.
We’re calling on New York State to fully fund the Quality Incentive Program in the upcoming New York State budget and codify it in statute, safeguarding high-quality, proactive healthcare statewide.
Dr. Andrew W. Brotman, MD
Executive Vice President and Vice Dean for Clinical Affairs and Strategy, Chief Clinical Officer, NYU Langone Health
Dr. Manisha Kulshreshtha, MD
Senior Vice President & Chief Clinical and Strategy Officer,
SBH Health System
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Leave-behind on QIP
The mainstream Medicaid Quality Incentive Program awards health plans that deliver high-quality care to their members. Under this program, plans that achieve superior results for their members receive bonus payments. Plans are measured on many of the key markers of health care disparities experienced by low-income communities and people of color, including whether pregnant women receive timely pre- and post- natal care, whether members receive timely breast and colorectal cancer screenings, and the proper management of asthma.
Ultimately, New Yorkers with Medicaid benefit from QIP when health plans and providers work together to deliver the highest quality healthcare possible. Health plans such as Healthfirst use QIP earnings to fund bonus payments to the highest-performing healthcare providers in their network. Many of the providers who receive quality awards are safety-net providers who would otherwise be unable to fund quality improvement initiatives. Healthcare providers have used their QIP-funded bonuses to hire additional staff to make phone calls to schedule patients for breast cancer screenings, purchase technology to remind parents about pediatric appointments for their children, and staff weekend and evening hours to expand access for working families.
The QIP is an administrative program, which means that it is not codified in statute at a set amount. As a result, funding for QIP has declined over time. While the Governor has proposed increasing funding for QIP in SFY 26, this proposal falls short of fully funding the program at $300M, jeopardizing the program’s ability to support proactive and preventative care for New York’s most underserved communities.
Many healthcare providers in New York’s highest-need neighborhoods rely on this program to ensure underserved populations get the care they need. QIP rewards health plans and providers for proactive and preventive care, such as cancer screenings, asthma management and behavioral health support. Without this additional funding, providers could be otherwise unable to fund programs to improve patient care. Healthcare providers use this finding in a variety of ways, such as:
Healthfirst is a not-for-profit insurer founded 30 years ago with a mission to make healthcare more accessible and equitable. We believe that every New Yorker deserves access to affordable, high-quality healthcare, and we’re committed to supporting policies that break down barriers so that underserved communities can access the care they deserve. We recognize the vital role of the Medicaid Quality Incentive program on millions of New Yorkers and are supporting this effort to advocate for full funding of the QIP program.
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