Newly Enrolled HPSJ Members – Requirement Initial Health Assessment (IHA) & Staying Health Assessment (SHA)

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Date: July 30, 2021
To: Health Plan of San Joaquin (HPSJ) CONTRACTED PCPs
From: Health Plan of San Joaquin
Subject: Newly Enrolled HPSJ Members – Requirement
Initial Health Assessment (IHA) & Staying Health Assessment (SHA)
Business: Medi-Cal

The Staying Healthy Assessment (SHA) is the Department of Health Care Services (DHCS) Individual Health Education Behavior Assessment (IHEBA). Plan providers are required to use and administer the SHA to all Medi-Cal beneficiaries as part of their Initial Health Assessment (IHA) and periodically re-administer it according to contract requirements.

  • All newly enrolled members must have a completed IHA (Initial Health Assessment) within the first 120 days of enrollment.
  • Members who have changed their PCP within the first 120 days of enrollment, now need a new IHA to be completed.

MORE IHA VALUE for Members and Providers –
An Initial Health Assessment helps ensure members are comprehensively assessed for acute, chronic and preventive healthcare needs. The IHA supports development of the new provider/patient relationship. Physicians and providers may also identify members whose health needs require coordination with community resources from other agencies.

HPSJ offers a $50 incentive to our PCPs for each member who received an IHA within 120 days of HPSJ enrollment. This provider incentive is based on claims/encounters received from both fees for service or capitated providers.

How do you qualify?

  • Minimum of 500 members must be paneled per qualifying PCP.
  • Panel must remain open the entire incentive year to qualify.

For more information about the SHA and IHA to support your practice:

Thank you for all you do to provide HPSJ patients outstanding health care! If you have questions, please contact Provider Services at 1.888.936.PLAN (7526).

Posted on August 2nd, 2021 and last modified on August 2nd, 2021.

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