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LHP strategic plan focus area – Maximizing financial performance

Last year Legacy Health Partners implemented a new source of revenue for our practices called the Clinical Integration Care Coordination PMPM (per-member, per-month) fund. This pool of money is dedicated to primary care providers to support their efforts with attributed patients while working toward the Medical Home model and/or pursuing higher tiers of Medical Home recognition.

In March, 60 primary care practices were eligible for a payment from the PMPM fund and either received a check or will receive a check with the annual CI incentive payout in June. PMPM payments will be calculated and paid out twice a year. 


Last year LHP made a number of changes to the clinical integration program incentive distribution methodology. First was the addition of patient attribution for primary care providers. PCPs are now eligible for additional incentive dollars based on the number of member months attributed to them under LHP agreements. Second is the direct distribution of Care Coordination “Per-member, Per-month” (PMPMs) dollars to PCPs to support their efforts with attributed patients and reward them for their Medical Home status.

The PMPM fund allows LHP to recognize and reward the investment of additional time, effort and resources needed to shift the model of care within LHP practices to provide patients with the highest level of care. Primary care providers are eligible for a percentage of the PMPM fund based on the number of LHP-attributed lives and Medical Home tier or NCQA recognition.

If you have any questions about the PMPM fund – or would like information and assistance with Medical Home certification – contact your LHP Field Operations Adviser.


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