Primary Care Provider/OB-GYN Incentive Program

Opportunity to Improve Quality for Your Patients

Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) builds healthier communities by investing in prevention. We have tools to help you identify your 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!

Primary Care Provider
Incentive Program

2024 Incentive Brochure

2024 Incentive Letter

2024 Participation Requirements

Practices must maintain a minimum of 50 Health Plan members.
Practice must remain open to new members the entire calendar year until they reach capacity.

Why Partner with HPSJ/MVHP?

Join our Network!

Which measures are incentivized?

2024 Quality Improvement Measures – HEDIS®

Behavioral Health Domain Measures
Follow-Up After ED Visit for Mental Illness – 30 Days (FUM)*	Follow-Up After ED Visit for Substance Abuse – 30 days (FUA)*

Children’s Health Measures
Child and Adolescent Well-Care Visits (WCV)*	Childhood Immunization Status: Combination 10 (CSI-10)*
Developmental Screening in the First 3 Years of Life (DEV)*	Immunizations for Adolescents: Combination 2 (IMA-2)*
Well-Child Visits in First 30 Months of Life: 0 to 15 Months, 6 or More Well-Child Visits (W30-6+)^	Well-Child Visits in First 30 Months of Life: 15 to 30 Months, 2 or More Well-Child Visits (W30-2+)^
Lead Screening in Children (LSC)

Chronic Disease Management Measures
Asthma Medication Ratio (AMR)^	Controlling High Blood Pressure (CBP)*	Hemoglobin A1c Control for Patients with Diabetes – HbA1c Poor Control (> 9%) (HBD)*

Reproductive Health Domain Measures
Chlamydia Screening in Women (CHL)^	Prenatal and Postpartum Care: Postpartum Care (PPC-Pst)^	Prenatal and Postpartum Care: Timeliness of Prenatal Care (PPC-Pre)^

Cancer Prevention Measures
Breast Cancer Screening (BCS-E)*	Cervical Cancer Screening (CCS)*	Colorectal Cancer Screening (COL)^

Incentive: $75^ or $100* for each qualifying member based on encounter/claim received for each of the 18 MCAS measures.

OB-GYNs qualify for any applicable measure within their scope of practice.

Additional Incentives for Performance Improvement*

If a measure increased in percentile from Calendar Year 2023, additional incentive amounts will be paid out in accordance with the table below. Incentive amounts are determined by level of achievement reached and are proportionate to the average number of assigned members during the calendar year.

*Per measure up to a maximum of 10 measures.

Check to see if your HPSJ/MVHP Patient is up to date with wellness visits here

Care GAP reports available on DRE Portal

Additional Incentives:
DHCS Value Based Payment
Federally Qualified Health Centers (FQHC)

If you have any questions please contact your HPSJ representative at 209.942.6340 or by email at ProviderServicesDepartment@hpsj.com.