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Practitioner Excellence Program

Introducing the Enhanced Provider Pay-for-Performance Program: Highmark Health Options Practitioner Excellence (HHOPE) Program

Highmark Health Options recognizes the vital role primary care providers play in our members’ health. To reward excellence and encourage high-quality, accessible care, we've developed a new pay-for-performance program. We've worked closely with an advisory group of network PCPs to develop this program. We’re pleased to invite you to participate. This program reflects our commitment to improving health and wellness in our communities.

Overview
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  • Providers must opt-in to the program to be eligible for payments.
  • Providers must meet the minimum membership requirements noted in the section below.
  • Each measure within the HHOPE Program requires the entity to have a minimum of 3 members in the denominator to qualify to be scored.
  • Following the completion of the 2025 HHOPE Program, eligible providers will receive one payment. Payment will be made by July 31, 2026, to allow for final claims runout and data analysis.
  • Payments can be earned through gap closure for each program measure.
Eligiblity Requirements
  • Minimum panel size requirements are membership of 5 at the entity level.
  • Primary Care Physicians: Family Practice, Internal Medicine, Pediatricians, Certified Registered Nurse Practitioners, Physician Assistants, Obstetricians.
  • Dentists (no minimum panel size required).
Program Guide

Download 2025 Highmark Health Options West Virginia Practitioner Excellence Program Guide (PDF)

Training

<link to training>

If you have any questions about the HHOPE Program, contact your Highmark Health Options Clinical Transformation Consultant.