CenCal Health, the Medi-Cal health plan for both Santa Barbara and San Luis Obispo counties, in April distributed $4.2 million in quarterly payments to participating primary care providers through the Quality Care Incentive Program (QCIP).
QCIP directly rewards CenCal Health plan providers who deliver exceptional medical care in their community, emphasizing the clinical priorities of significance to Medi-Cal members, such as diabetes and asthma care, breast cancer and cervical cancer screenings, and child and adolescent well-care visits.
To promote health equity, QCIP payments are also tied to the diversity of members cared for by each provider. Payments to plan providers increase to reflect the proportion of patients of greater clinical complexity, for example, the aged or those disabled.
“To have communities that truly thrive, quality health care needs to be available to everyone,” said CenCal Health CEO Marina Owen. “QCIP helps CenCal Health and the local provider community improve health outcomes.
“Through QCIP and our participating providers, health plan members receive exceptional diagnostic and preventative medical services that can make a significant difference in their overall health and wellness.”
The most recent QCIP distribution went to 87 primary care providers (PCPs) on the Central Coast. Recipients can be single physician providers or physician groups.
Top providers based on performance for the first quarter of 2024 (January-March) include Jeffrey Kaplan, MD Inc. Pediatric Medicine in Santa Maria; Santa Barbara pediatrician Augusto Castañeda, MD; Community Health Centers of the Central Coast – Advanced Primary Care; Pediatric Medical Group of Santa Maria, and Lompoc pediatrician Cindy Blifeld, MD.
“The power of this incentive program is that it encourages the use of evidence-based treatment, screening, and preventive health services, supporting the goal of delivering top quality patient care,” said Carlos Hernandez, CenCal Health executive Quality & Population Health officer.
“Some QCIP aspects of care that had the greatest improvement include medication management for people with depression, lead testing in children, and well-child visits before 15 months of age,” Hernandez said.
In January, QCIP payments totaling $4.16 million were made to local Medi-Cal providers for the last quarter of 2023. Since the program’s launch in 2022, CenCal Health has distributed some $31 million in QCIP funds to participating Central Coast PCPs.
Sansum Clinic is another one of CenCal Health’s QCIP participants. “QCIP helps providers like Sansum by delivering both information and funding to more fully support the physician-patient relationship,” said Dr. Marjorie Newman, Sansum Clinic medical director.
“We are grateful for this innovative program that maximizes medical services, especially preventative care, on behalf of our patients,” Dr. Newman said.
More on CenCal Health is available at cencalhealth.org.