Physician Incentive Program Delivers $16 Million in Health Care

In 2025 CenCal Health, the Medi-Cal managed care plan, distributed more than $16 million to 95 local primary care providers through its Quality Care Incentive Program (QCIP), driving improvements in patient care across Santa Barbara and San Luis Obispo counties.

QCIP rewards CenCal Health providers for excellence in key clinical areas, including diabetes and asthma management, breast cancer and cervical cancer screenings, and pediatric well-care.

QCIP payments are also tied to the clinical complexity of members cared for by each primary care provider (PCP).

Payments increase to reflect the proportion of patients with complex medical needs, for example, the aged or those who are disabled, CenCal said.

Top QCIP performers included Dr. Jeffrey Kaplan, Inc. Pediatric Medicine in Santa Maria; Lompoc pediatrician Dr. Cindy Blifeld; Jackson Medical Group; Community Health Centers of the Central Coast; and Sansum Clinic, now part of Sutter Health.
 
“Providing incentives for quality improvement has been a long-standing focus at CenCal Health and enables our primary care providers to uphold exemplary standards of care,” said Marina Owen, CenCal Health CEO. “We appreciate the exceptional performance of our local physicians and their dedicated teams.”

Since QCIP was launched in March 2022, many individual aspects of care have improved significantly across the Central Coast, such as antidepressant medication management from a baseline of 57.3% to 74.1% compliance with treatment guidelines, CenCal Health reports.

Well-child visit utilization for infants at 15 months of age improved from 50.6% to 70.6%, chlamydia screening in women improved from 57.3% to 67.3%, and lead testing in children also improved from 59.1% to 76.4% compliance with established guidelines, CenCal Health said.

Developmental screening in children in the first three years of life – a new aspect of care introduced to QCIP – also improved from a baseline of 49.7%-61.5%. To date, over $56 million has been paid to Central Coast PCPs since the quality program’s inception three years ago.
 
“CenCal Health’s innovative QCIP analytics system is foundational to effective Population Health Management,” said Carlos Hernandez, CenCal Health chief quality officer.

“Since its 2022 implementation, QCIP has enabled meaningful improvement and even greater compliance with evidence-based standards of care for CenCal Health members,” Hernandez said.

Participating in QCIP since its launch, Sansum Clinic has consistently been a top performer at four of its area clinics.

Dr. Marjorie Newman, Sansum Clinic chief medical officer, a collaborative participant in the program, played an important role in the initial development of QCIP.

“By rewarding high-quality, patient centered care, CenCal Health’s QCIP program helps us better serve individuals who are medically complex or resource limited,” said Dr. Newman.

“Programs like this advance our commitment to health equity by directing resources toward patients with the highest medical and social needs, strengthening our ability to deliver high quality, coordinated care to those who are most vulnerable,” Dr. Newman said.

“We are very grateful to CenCal Health for their collaboration and support in this shared endeavor.” she said.

Last month, CenCal Health received two Achievement Awards for Outstanding Quality Performance by the state of California.

At the annual California Department of Health Care Services (DHCS) Quality Conference, CenCal Health was recognized for outstanding results in both Overall Performance and Children’s Health Domain categories of the Managed Care Accountability Set for Measurement Year 2024.

Of the 23 Medi-Cal plans statewide, only four, including CenCal Health, received the distinction for overall performance. The Managed Care Accountability Set represents DHCS’s highest-priority quality measures, used annually to evaluate Medi-Cal plan performance.

Accepting the awards in Sacramento was Lauren Geeb, CenCal Health senior director of Quality & Population Health.

“Earning recognition in both the overall and children’s domains underscores CenCal Health’s commitment to delivering outstanding quality care to its members and the community,” said Geeb.

Hernandez headed up the implementation of the Quality Care Incentive Program at CenCal Health and is widely recognized for his overall impact on the Central Coast healthcare community.

During his 31-year tenure, Hernandez led the evolution of CenCal Health’s Quality Improvement System, overseeing regulatory compliance, pay-for-performance initiatives, and HEDIS reporting.

He has served as a leader and liaison to the health plan’s provider network, advancing quality and population health.

Hernandez is retiring after more than three decades of distinguished service.

“Carlos leaves a legacy of quality improvement and health equity that will certainly continue at CenCal Health, and throughout doctors’ offices, medical clinics and community health centers in multiple communities on the Central Coast,” said Owen.

More on CenCal Health is available at cencalhealth.org. To review CenCal Health’s 2024/25 Community Report, visit CenCal2025.org.