2022 Primary Care Providers Incentives – UPDATED (This Supersedes alert sent on 12/29/2021)

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Date: February 17, 2022
To: All HPSJ Primary Care Physicians (PCP) only
Provider Alert Type: Informational/Educational and Procedural Update
From: Health Plan of San Joaquin
Subject: 2022 Primary Care Providers Incentives – UPDATED
(This Supersedes alert sent on 12/29/2021)
Business: Medi-Cal

Health Plan of San Joaquin (HPSJ) is pleased to announce the 2022 Provider Incentive Program promoting Quality Care to our members. The requirements for participation include the following qualifiers:

2022 Qualifiers to Participate
1. Maintain a minimum of 500 HPSJ members per assigned provider
2. Clinic(s) must remain open to new members the entire calendar year

The Quality Measures include Healthcare Effectiveness Data and Information Set (HEDIS) and the Managed Care Accountability Sets (MCAS) – performance measures that the Department of Health Care Services (DHCS) selects for annual reporting by Medi-Cal managed care health plans. The PCP Clinical Measures include 8 HEDIS/MCAS quality measures including IHA. These quality measures are paid $50 per encounter.

2022 Quality Measures for Primary Care Providers

• BCS – Breast Cancer Screening
• CCS – Cervical Cancer Screening
• CHL- Chlamydia Screening
• CIS – Childhood Immunization Status Combination 10
• CBP – Controlling High Blood Pressure
• HBD-HbA1c Poor Control– (lower is better)
• LSC- Lead Screening in Children
• IMA – Immunizations for Adolescents Combination 2
• W30 – Well Child visits in the first 30 months of life (6+ Visits in 15 months and 2+ visits 15-30 months)
• WCV – Well Child Visits 3-21 years
• IHA – Initial Health Assessment – within 120 days of new member enrollment

HPSJ looks forward to our continued partnership in providing high quality care to our members. Your engagement as a provider not only helps HPSJ members receive care, but it also helps us improve the health status of the overall community.

We appreciate your work and continued partnership. If you have questions, please contact your Provider Services Representative, directly or Customer Services at 888.936.7526.

Posted on February 17th, 2022 and last modified on September 8th, 2022.

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