Initial Health Appointment (IHA)

An IHA is a comprehensive assessment of a patient's health status completed during the initial visit(s) with their primary care provider (PCP). During the IHA, the PCP assesses and manages the patient’s acute, chronic and preventative health needs. The California Department of Health Care Services (DHCS), Managed Risk Medical Insurance Board (MRMIB) and Centers for Medicare and Medicaid Services (CMS) require PCPs to conduct an IHA with every newly enrolled HPSM member within 90 days of being assigned as the member’s PCP (an exception is made if the HPSM’s member’s medical record contains complete information updated within the previous 12 months).

General IHA requirements

To meet DHCS’s requirements, an IHA must:

• Be completed by a provider within the primary care medical setting.
• Be performed in a way that is culturally and linguistically considerate.
• Be documented in a member’s medical record.
• Include: 
  • A history of the member’s physical and mental health.
  • An identification of risks.
  • An assessment of need for preventive screens or services.
  • The diagnosis and plan for treatment of any diseases.
  • Any additional health education provided.

Find out who your newly assigned members are

HPSM publishes a monthly Excel file to the eReports Portal called the “Active Engagement Report” that includes a list of all actively assigned members. This report allows PCPs to identify which empaneled members are due for an IHA based on their assignment date.

Resources

• Primary Care eReports User Guide
• Initial Health Appointment Training
• Initial Health Appointment Training Confirmation Form

Contact

• Email: quality@hpsm.org