Value-Based Programs

Value-based programs provide incentives for high-quality and cost-effective care, member service and convenience, and health data submission. Manuals and measures are found as follows.

For assistance, please contact your Provider Network Account Executive.

Medicaid expansion metrics

As of December 1, 2023, North Carolina Department of Health and Human Services (NC DHHS) requires that Medicaid expansion member data be included in AmeriHealth Caritas North Carolina (ACNC) performance metrics.

The NaviNet provider portal offers two practice performance scorecards:

  1. Metric including the Medicaid expansion population
  2. Metric excluding the Medicaid expansion population

Since August 2024, Medicaid expansion members may affect performance on the below measures. Child and pregnant member measures are not included. NC DHHS set annual quality performance targets for 8 of the 13 Advanced Medical Home (AMH) measures. The target is 5% relative improvement from the prior year’s baseline. For additional information, visit NC DHHS.

  • Cervical Cancer Screening (CCS)
  • Chlamydia Screening in Women (CHL)
  • Colorectal Cancer Screening (COL)
  • Controlling High Blood Pressure (CBP)
  • Glycemic Status Assessment (GSD)
  • Plan All-Cause Readmissions (PCR)
  • Screening for Depression and Follow-Up Plan (CDF)
  • Total Cost of Care (TCOC)

3MTM Health Information System (HIS) Medical Home Dashboard

The 3M Medical Home Dashboard supports the implementation of accountable care programs, medical homes and other programs by providing users with quick, easy access to critical key performance indicators. The dashboard is refreshed by 3M once a month to make the most up-to-date data available to users.

After submitting the required form and receiving approval to have access, you can access the 3M Health Information System (HIS) online portal using your email address as your user ID.

Program manuals and support details

Providers