Health Plan of San Joaquin builds healthier communities by investing in prevention. We have tools to help you identify your HPSJ Medi-Cal patients due for services. Our Provider Services team will partner with your staff to achieve optimal results.
Thank you in advance for your support in improving health and potentially reducing preventable diseases in our members. Schedule your patients for preventative services today and increase your earning potential!
What are the measures being incentivized?
| Effective January 1, 2022 through December 31, 2022 | ||
| Quality Improvement Measures - HEDIS® | Description for Providers - HEDIS® Measure | Incentive Per Measure* |
| Primary Care Provider Only | ||
| Breast Cancer Screening | Women 50 - 74 years of age who had a mammogram to screen for breast cancer. | $50 |
| Cervical Cancer Screening (CCS) | CCS women 21-64 years of age who were screened for cervical cancer. | $50 |
| Childhood Immunization Status Combination 10 (CIS) | Children received Combination 10 vaccines by age 2. | $50 |
| Chlamydia Screening (CHL) | Women 16–24 years of age who were identified as sexually active and who had at least one test for chlamydia during the measurement year. | $50 |
| Controlling High Blood Pressure (CBP) | Adults 18-85 years of age who were diagnosed with hypertension and whose blood pressure was adequately controlled (<140/90 mmHg). | $50 |
| HBD-HbA1c Poor Control | Hemoglobin A1c Control for Patients With Diabetes: HbA1c Poor Control (>9.0%)* | $50 |
| IMA- Immunizations for Adolescents Combination 2 | Adolescents received Combination 2 vaccines by age 13. | $50 |
| Initial Health Assessment (IHA) | IHA is first 120 days after enrollment into the plan. | $50 |
| Lead Screening in Children (LSC) | Children 2 years of age who had one or more capillary or venous lead blood test for lead poisoning by their second birthday. | $50 |
| Well-Child Visits (W30) (Calculated as 2 separate measures) | Well child visits in the first 30 months of life.
| $50 $50 |
| Well-Child Visits 3-21 (WCV) | Annual well child visit for 3-21 year olds. | $50 |
| *The HPSJ Provider Incentive Program payment is issued based on the incentive description and is computed from claim/encounter data only. See the incentive chart above for details. Funds will be distributed semi-annually. | ||
If you have any questions please contact your HPSJ representative at 209.942.6340 or by email at ProviderServicesDepartment@hpsj.com.
Posted on January 29th, 2020 and last modified on March 24th, 2022.
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