Skip to main content
Labor Day Holiday Día del Trabajo

Texas Children's Health Plan will be closed on Monday, September 1st, in observance of Labor Day. In our absence, you can reach our after-hours nurse help line at 1-800-686-3831. We will resume normal business hours on Tuesday, September 2nd. Wishing you a safe and happy Labor Day!

Texas Children's Health Plan estará cerrado el lunes 1 de septiembre por el Día del Trabajo. Durante nuestra ausencia, puedes comunicarse con nuestra línea telefónica de ayuda fuera del horario habitual al 1-800-686-3831. Reanudaremos nuestro horario regular el martes 2 de septiembre. ¡Te deseamos un feliz y seguro Día del Trabajo!

New Rewards Coming Soon! ¡Se vienen nuevas recompensas!

Our Healthy Rewards Program is getting an update in September! For a sneak peek of all the changes - including new rewards and ways to redeem them - please click here.

¡Nuestro Programa Healthy Rewards tendrá su actualización en septiembre! Para ver un adelanto de todos los cambios, incluyendo nuevas recompensas y formas de canjearlas, haz clic aquí.

Updates to the Provider Incentive Program

Attention: Primary Care Providers Effective Date: August 2020 Texas Children’s Health Plan would like to thank you for the dedication and care you continually provide to our valued members. We appreciate all your effort in improving the quality of care our members receive every day. Our HEDIS metrics are just one way we see that outcome, and it is reflected in our provider incentive program (PIP) results. We would like to share an update made to our PIP because of your feedback. We value your partnership and take your comments seriously. You have provided meaningful input on this program and we have implemented enhancements accordinglyHow this impacts providers: As of August 2020, we are modifying the member attribution algorithm to a provider for the purposes of calculating the HEDIS scores for the incentive programs.  Previous algorithmMeasured PCP performance based on members who were attributed to the PCP at the end of the HEDIS measurement period Updated algorithmMeasure PCP performance based on the following member attribution logic 
Measure  Previous Algorithm Updated Algorithm 
W15-well-child visits in the first month of life (6 or more visits) PCP at the end of the calendar year The PCP at the end of the 15 month period for each member 
IMA- Immunizations for Adolescents (Combination 2). The percentage of adolescents turning 13 who had the immunizations Meningococcal, Tdap and HPV. PCP at the end of the calendar year The PCP at the member’s 13th birthday 
URI- Appropriate treatment for children with Upper Respiratory Infection (URI) PCP at the end of June of each year The PCP at the event date  
Providers will see this change in the incentive payment that is scheduled to be made August 2020. Next steps for providers: No action required.  If you have any questions, please email Provider Network Management at: providerrelations@texaschildrens.org. For access to all provider alerts, log into:www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.