Overview
The Oregon Health Authority’s Quality Incentive Program (QIP) is designed to enhance the quality of care for Oregon Health Plan (OHP) members by offering financial incentives to Coordinated Care Organizations (CCOs). These incentives are tied to performance on specific health care quality measures, known as “incentive metrics,” which are selected annually by the Metrics and Scoring Committee—a public body comprising measurement experts, CCO representatives, and community members. The committee also sets the benchmarks and improvement targets that CCOs must meet to earn these bonuses. In 2024, the program allocated over $300 million in bonus payments statewide, emphasizing its significant role in driving improvements in areas that matter most to OHP members.
The QIP encompasses both “downstream” and “upstream” measures. Downstream measures focus on traditional medical services, such as disease prevention and treatment, and are selected from the CMS Child and Adult Core Sets. Upstream measures address social determinants of health (SDOH), including factors like housing, food security, and transportation. The Metrics and Scoring Committee is mandated to include at least four upstream measures each year, reflecting Oregon’s commitment to addressing the broader factors influencing health outcomes. Public transparency is a cornerstone of the program, with CCO performance on all incentive measures being publicly reported, ensuring accountability and fostering community trust.
More information about the QIP can be found on the OHA website:
Do you have questions or want to get more involved in quality metrics?
Contact us at UHQualityImprovement@umpquahealth.com.

2025 Incentive Measures & Resources
At Umpqua Health, we are dedicated to improving the health and well-being of our members through strong partnerships with providers and community organizations. Our work is guided by the Coordinated Care Organization (CCO) incentive measures, which help drive quality improvement and support better outcomes across our network.
Below, you’ll find summaries of each incentive measure, along with the programs and resources we offer to support both providers and members. Each year, we also publish an Incentive Measure Binder that includes detailed summaries and the Oregon Health Authority’s (OHA) technical specifications for each measure.
Adults with Diabetes – Oral Evaluation:
Assesses the percentage of adults with diabetes who receive a comprehensive oral health evaluation annually, recognizing the link between oral health and diabetes management.
- Oral Health Tips for Managing your Diabetes: This document outlines the importance of diabetic members visiting their dentist.
- Make Sure You Go to the Dentist: This document outlines the steps for connecting to a dental provider.
Assessments for Children in ODHS Custody:
Tracks children entering foster care receiving appropriate physical, mental, and dental health assessments within 60 days of custody.
Child and Adolescent Well-Care Visits:
Measures the proportion of children and adolescents who have had a well-care visit during the measurement year.
- Growth Milestones: This document provides information on the milestones children reach from birth – 5 years.
- Well Child Visit Guidelines: This document provides guidelines for what to expect at each well child visit by age.
- Healthy Start Gift Card Program: (ages 0-6): Children aged birth to 6 who had their well child visit or immunizations by December 31, 2025, can get a $15 gift card per service (up to $75).
Childhood Immunization Status (Combo 3):
Tracks the percentage of children who have received a specified set of vaccinations by their second birthday.
- Healthy Start Gift Card Program: (ages 0-6): Children aged birth to 6 who had their well child visit or immunizations by December 31, 2025, can get a $15 gift card per service (up to $75).
Diabetes: HbA1c Poor Control:
Assesses the proportion of adults with diabetes who have poor blood sugar control (HbA1c >9%), aiming to encourage better diabetes management.
- Diabetes Self-Management Program: Members with Diabetes are eligible to participate in this program which includes a) One-on-one care planning with a lifestyle coach or diabetes educator to set personal health goals, and b) A 6-week series of evidence-based group classes (2.5 hours/week), led by trained facilitators, at least one of whom has personal experience with diabetes.
Immunizations for Adolescents (Combo 2):
Measures the percentage of adolescents who have received recommended vaccines, including meningococcal, Tdap/Td, and HPV, by their 13th birthday.
- Take a Shot at Cancer!: This resource outlines the importance of the human papillomavirus, or HPV. The resource emphasizes that the vaccination protects against this virus and the cancers it can cause.
- Healthy Start Gift Card Program: (ages 9-12): Children aged 9 to 12 who had their immunizations by December 31, 2025, can get a $15 gift card per service (up to $75).
Initiation and Engagement of Substance Use Disorder (SUD) Treatment:
Evaluates the percentage of members with a new SUD diagnosis who initiate and engage in treatment within specified timeframes.
Meaningful Language Access (Health Equity):
Assesses the provision of language access services to ensure that members with limited English proficiency receive culturally and linguistically appropriate care.
- How do I schedule interpreter services?: This document outlines options for providers to use when scheduling interpreter services with a Qualified or Certified Health Care Interpreter (HCI) for UHA members as required by Oregon Administrative Rule (OAR) 950-050.
- How to become a qualified or certified health care interpreter: A detailed checklist of requirements related to becoming a health care interpreter.
- Provider Language Proficiency Requirements: A detailed document outlining language proficiency requirements for providers who conduct in-language services with members.
- Language Access Resource Binder: This resource is a one-stop view of all Language Access Program initiatives available from UHA.
- Health Care Interpreter Scholarship : UHA launched a scholarship program for Douglas County professionals to become OHA Qualified or Certified health care interpreters. Interested individuals should complete the application here .
- Language Access Plan: This document outlines key initiatives and requirements related to language access within the UHA service area.
- Language Access Member Poster | Flyer English | Flyer Spanish: These documents outline steps for members to request an interpreter.
Prenatal and Postpartum Care: Postpartum Care Rate:
Measures the percentage of patients who had a postpartum visit between 1 and 12 weeks after delivery.
- Postpartum Care Coding Guidance: This document identifies commonly used postpartum service codes from the PPC measure specification to simplify and reduce the burden of manual reporting through chart review. These codes would need to be billed outside of the global billing process.
Preventive Dental or Oral Health Services (Ages 1-5 and 6-14):
Tracks the percentage of children in specified age groups who received preventive dental services.
- First Tooth Training: Become First Tooth certified to perform fluoride varnish treatment at your clinic.
Screening for Depression and Follow-Up Plan:
Measures the percentage of members screened for depression with a documented follow-up plan when necessary.
Assesses the extent to which CCOs screen members for social needs (e.g., housing, food insecurity) and provide appropriate referrals, addressing broader factors affecting health.
- Social Determinants of Health Screening Guidance: This document assists clinical partners in selecting from the many available screening tools approved by OHA, Umpqua Health has identified two commonly used tools approved by the National Committee for Quality Assurance (NCQA) and the Centers for Medicare & Medicaid Services (CMS).
- Collaborative Social Needs Screening & Referral Training: This document provides guidance on SDoH training including cultural responsiveness & equitable practices, empathic inquiry & motivation interviewing, and trauma-informed practices.
- Health-Related Services Overview: This document provides an overview of Health-Related Services, such as how to request services and what services are covered.
- Indigenous Social Determinants of Health: UHA recognizes the unique social, economic, and cultural factors that impact the health of Indigenous communities. In Oregon, nine federally recognized tribes represent a rich and diverse heritage and understanding the American Indian and Alaska Native (AIAN) population’s health requires a holistic approach that acknowledges these communities’ specific needs.
- Social Determinants of Health Plan Roadmap : UHA has developed an SDoH Action Plan Dashboard, building on a comprehensive gap analysis, to increase community-based organization (CBO) capacity by providing resources for financial and staffing support. This plan aligns with key initiatives such as the use of Health-Related Services (HRS) funds and the Supporting Health for All through REinvestment (SHARE) Initiative. The action plan also focuses on refining screening and referral workflows, continued implementation of Unite Us, improving data utilization, and providing training and reporting support to providers and CBOs.
Social Emotional Health for Young Children:
Evaluates the availability and utilization of social-emotional health services for young children, supporting early childhood development.
- Asset Maps: Our Social Emotional Asset Maps are designed to help providers and members identify contracted providers available to serve young children birth to five. The asset map helps Umpqua Health understand the capacity and characteristics of existing behavioral health services and providers, identifying strengths and gaps in the system. Our annual asset mapping is a strategic, phased process aimed at improving access to and coordination of social-emotional health services for young children. It provides a foundation for data-informed planning and community collaboration to build a more effective and equitable service network. You can find our asset maps in our Provider Directory, in the top right box titled “downloads”
- Social Emotional Scholarship: Providers interested in completing training (s) to increase capacity, skills, and knowledge in treating children birth to five can review the menu of training options and resources in this program flyer. Primary care providers, integrated behavioral health providers and specialty behavioral health providers can all apply.
Social Determinants of Health (SDOH): Social Needs Screening and Referral: