Primary Care Value-Based Payment Program
HPSM's Primary Care Value-Based Payment program offers performance bonus payments to in-network primary care providers for meeting targeted quality measures. The program is designed to improve outcomes by sharing data with HPSM providers on care information for their assigned HPSM patients. The targeted quality performance measure set focuses on member access and preventive care services.
For questions on this program, or how to participate in the review process in partnership with HPSM, please contact HPSM Provider Services at PSInquiries@hpsm.org.
Guidelines & Measures
Medi-Cal Primary Care
Review descriptions of individual measures, specific requirements, and required forms and CPT codes to receive incentives for Medi-Cal members.
CareAdvantage Primary Care
Review descriptions of individual measures, specific requirements, and required forms and CPT codes to receive incentives for CareAdvantage members.
Additional Resources
- 2022 Attestation Template for P4P
- 2022 eReports User Guide - Primary Care
- Asthma Medication Ratio Tip Sheet
- Avoidable ED Visit Codes
- Claims and Encounter Data Submission
- CPT II Coding Tip Sheet
- List of High Risk Medications (DAE)
- Outpatient Visit Codes
Webinars
Medi-Cal 2020 Primary Care Benchmark P4P Program Webinar December 6, 2019
Please note: program measures have been updated since the time of this webinar. For updated measure information please refer to the Medi-Cal Benchmark P4P Program Guidelines above.
Medi-Cal 2020 Primary Care Benchmark P4P Program Slide Deck (469.68 KB PDF)
Medi-Cal 2019 Primary Care Benchmark P4P Program Webinar April 25, 2018
Please note: program measures have been updated since the time of this webinar. For updated measure information please refer to the Medi-Cal Benchmark P4P Program Guidelines above.
CareAdvantage 2020 Primary Care P4P Program Webinar December 13, 2019
Please note: program measures have been updated since the time of this webinar. For updated measure information please refer to the most recent CareAdvantage Benchmark P4P Program Guidelines above.
CareAdvantage 2020 Primary Care P4P Program Slide Deck (410 KB, PDF)
P4P Forms
Give us your feedback!
Please send us your questions or comments on the Medi-Cal Primary Care and/or CareAdvantage Primary Care Value-Based Payment Program Guidelines.