IMPORTANT: Changes to Medi-Cal rules are coming! Medi-Cal will be available to all people who are 50 years of age or older who meet all Medi-Cal eligibility criteria, and immigration status will not matter. These changes will also let people keep more property and qualify for Medi-Cal. Go to benefitscal.com or call the Los Angeles County Department of Public Social Services at 1-866-613-3777.

Pay-for-Performance (P4P) Program

Welcome to L.A. Care Health Plan’s Physician Pay-for-Performance (P4P) Program. The Physician P4P program offers performance-based incentives to qualified high-volume physicians and higher-volume Community Clinics that provide high-quality preventive and chronic care to L.A. Care members.

Eligibility

This program is open to:

  • Solo and small group physicians with 250 or more assigned L.A. Care Medi-Cal members

OR

  • Community Clinics with 1,000 or more assigned L.A. Care Medi-Cal members

How to Participate

There is no need to sign-up for L.A. Care’s P4P program. Eligible high-volume physicians and higher-volume Community Clinics are automatically enrolled in L.A. Care’s P4P program and can earn incentive payments by providing qualifying services to L.A. Care members and submitting associated Encounter data.

Data Submission Information

L.A. Care’s P4P program uses administrative HEDIS® data to determine incentive payments. Please review our HEDIS resources for more information. Data must be submitted via your usual reporting channels for it to be considered for the P4P program. 

blocks showing data channel path

You can also view L.A. Care's P4P Measure Grid for more information.

Payments

Payments are remitted using Taxpayer Identification Number (TIN) from a submitted W-9 form. If you are unsure if your Tax Information is up-to-date, please contact us to verify.