2026 Clinician Incentive Program
CareMore deeply appreciates your commitment to our patients and their outcomes. The 2026 Clinician Incentive Program is designed to reward exceptional care. Participating Clinicians have the opportunity to earn up to $490 per paneled patient per year, or $49K for a 100 patient panel.
Incentive Structure
| Component | Performance Measure | Payout |
|---|---|---|
| Overall STARS Rating | 4 STAR/ 4.5 STAR/ 5 STAR | $70 / $100 / $120 PMPY |
| Overall STARS Improvement | ≥0.25 STAR Improvement | $10 PMPY |
| PAHAF* & AWV** Submission | Dates of service: 1/1/26-6/30/26 | $350 per form with AWV code |
| PAHAF & AWV Submission | Dates of service: 7/1/26-12/31/26 | $250 per form with AWV code |
| PAHAF Completion & Accuracy | 85%+ completion & accuracy | $10 per payable form |
Eligibility & Payment
- TINs must have 25+ patients during measurement period (1/1/2026–12/31/2026) to be eligible for STARs. PAHAF and AWV have no minimum patient requirement and will be offered based on the number of eligible patients empaneled. All payouts will be based on aggregate TIN performance.
- Payments for PAHAF & AWV submissions will be made monthly starting in April, payments for PAHAF completion & accuracy will be made in Q1 2027, and payments for STARs measures will be made in Aug 2027.
- Providers that are terming before 12/31/2026 must submit PAHAFs on the portal prior to access being removed for payment. Providers will not be eligible for the quality bonus if they term before 1/1/2027.
STARs Metrics
- STARs metrics will be aligned with plan STARs cut points and weighted measures to be released in Q1 2026.
- STARs improvement will be calculated by comparing this year’s overall STARs rating to last year’s rating.
PAHAF & AWV Metrics
- To be eligible for payment, a claim with an acceptable AWV code (G0402, G0438, G0439, 99381-99397) must be submitted to CareMore within 90 days of service or by the program deadline of Friday, January 8, 2027, for Q4 encounters along with the PAHAF.
- PAHAF completion is defined as PAHAF submitted/total PAHAF available. Accuracy is defined as payable PAHAF submitted/total PAHAF submitted. A payable PAHAF requires all responses to match the submitted medical record for eligible dates of service. Providers can resubmit corrected PAHAF forms if necessary.
CareMore is here to help
Our team is invested in your success and here to help each TIN earn the maximum possible payout. Expect us to meet with you monthly to review your progress and know you can reach us anytime with questions or support requests.
* PAHAF: Patient Annual Health Assesment Form
**AWV: Annual Wellness Visit