All PlansAdministrativeMedium impact
Updated 2026 PIP Manual now available
Priority Health·Quality & Incentives
We identified it
Sep 1, 2026
Summary
Priority Health updated the 2026 PCP Incentive Program (PIP) Manual with three clarifications: (1) removed 'required' designation from the SDoH use case for MiHIN Health Information Exchange participation since it may sunset, though SDoH data can still be submitted via QMI; (2) added definition for 'Anchor Date' in the glossary; (3) clarified that PIP_011G and PIP_011H reports are informational only, with PIP_011C as the authoritative source for HbA1c and blood pressure gap closure metrics.
Action Required
REQUIREMENTS: Immediately review the updated 2026 PIP Manual (accessed via Provider Incentives webpage with login) to understand the three changes. Billing and quality reporting team should: (1) Update any internal processes that referenced SDoH submission as 'required' to MiHIN—clarify that it is now optional; (2) Ensure staff are aware of the new 'Anchor Date' definition in Appendix 4 and apply it correctly in gap closure calculations; (3) Update reporting workflows to use PIP_011C (not PIP_011G or PIP_011H) as the authoritative source for HbA1c and blood pressure gap closure reporting. If your practice submits SDoH data, confirm it continues via QMI rather than relying on MiHIN use case. Failure to use the correct source report (PIP_011C) may result in inaccurate incentive calculations.