Provider Incentive Programs
HPSM offers incentive programs that supplement standard reimbursement for primary care clinics and nursing facilities. These four incentive programs are pay for performance (P4P) programs, or metrics-based incentives designed to help providers meet quality performance targets to improve outcomes and experience for HPSM members.
These incentives help us build and maintain a more diverse and well-resourced provider network.
Incentives for Primary Care Providers
- Care Gap Closure P4P offers providers real-time bonus payments through a web-based platform for individual efforts to close priority care gaps.
- Benchmark P4P is designed to improve outcomes by sharing data with HPSM primary care clinics on quality performance for their patients.
Incentives for Nursing Facilities
- Nursing Facility P4P is designed to improve quality of care by increasing member bed access, reducing inpatient and emergency department utilization, and improving care transitions.
- Community Discharge P4P incentivizes successful discharging of HPSM members from extended institutional stays to community settings where they remain for at least six months.
- Skilled Nursing Facility Workforce Quality Incentive Program (SNF WQIP) is a Department of Health Care Services initiative that provides bonus payments to eligible SNFs that improve workforce stability and quality of care for Medi-Cal members.
For questions about our P4P incentives, email [email protected].