L.A. Care Health Plan's Physician Pay-For-Performance (P4P) Program provides financial rewards for solo, small group and clinic practices that provide high quality care for L.A. Care Medi-Cal members (including those with plan partners Anthem Blue Cross and Blue Shield of California Promise Health Plan).
Primary care providers have an opportunity to receive significant revenue above capitation. Eligible providers can qualify to receive annual incentive payments for outstanding performance and year-over-year improvement on multiple HEDIS® measures. In addition, the program has an Access and Availability Payment Gate, which is based on results from the Department of Managed Health Care-required surveys.
Solo practices must have 250 or more and clinic organizations must have 1,000 or more assigned Medi-Cal members to qualify for the program. There is no need to sign up as eligible providers are automatically enrolled in the program.
Year Eight of the program is happening now! The Year Seven (2017) program is expected to be paid out in the 4th quarter of this year.
For more information on the program and to see if you qualify, please contact us.