2022 Primary Care Providers Incentives
| Date: | December 29, 2021 |
| To: | All HPSJ Primary Care Physicians (PCP) only |
| Provider Alert Type: | Informational/Educational and Procedural Update |
| From: | Health Plan of San Joaquin |
| Subject: | 2022 Primary Care Providers Incentives |
| Business: | Medi-Cal |
Health Plan of San Joaquin (HPSJ) is pleased to announce the 2022 Provider Incentive Program promoting Quality Care to our members. The requirements for participation include the following qualifiers:
2022 Qualifiers to Participate
- Maintain a minimum of 500 HPSJ members per assigned provider
- Clinic(s) must remain open to new members the entire calendar year
The Quality Measures include Healthcare Effectiveness Data and Information Set (HEDIS) and the Managed Care Accountability Sets (MCAS) – performance measures that the Department of Health Care Services (DHCS) selects for annual reporting by Medi-Cal managed care health plans. The PCP Clinical Measures include 8 HEDIS/MCAS quality measures including IHA. These quality measures are paid $50 per encounter and NOT part of the Value Based Payment program.
2022 Quality Measures for Primary Care Providers
- BCS – Breast Cancer Screening
- CCS – Cervical Cancer Screening
- CIS – Childhood Immunization Status Combination 10
- CBP – Controlling High Blood Pressure
- CDC-HbA1c Test – Comprehensive Diabetic Care
- IMA – Immunizations for Adolescents Combination 2
- W30 – Well Child visits in the first 30 months of life
- WCV – Well Child Visits 3-21 years
- IHA – Initial Health Assessment – within 120 days of new member enrollment
HPSJ looks forward to our continued partnership in providing high quality care to our members. Your engagement as a provider not only helps HPSJ members receive care, but it also helps us improve the health status of the overall community.
We appreciate your work and continued partnership. If you have questions, please contact Provider Services at 209.942.6320 or Customer Services at 888.936.7526 .