Incentives

Value Based P4P Incentives

The Value Based Pay for Performance recommended incentive design is a shared savings model that relies not only on quality but also cost and resource use. While the design recommends payment based on high quality, managed cost, and appropriate resource use, each health plan determines its own budget and methodology for calculating and distributing payments to physician organizations. Additional detail about the standard incentive design can be found in the resources below.

Value Based P4P Standard Incentive Design Overview

Fact Sheet: Value Based Pay for Performance for Physician Groups - Key Pay-for-Performance Design Decisions​

Issue Brief: Charting a Course to Value in Physician Group Payment - Key Pay-for-Performance Design Decisions

Total Cost of Care

To help California physician organizations reduce unnecessary costs, the Integrated Healthcare Association developed a total cost of care (TCC) measure to complement existing clinical quality and patient experience measures used in the Value Based P4P program.

Fact Sheet: Total Cost of Care

Value Based P4P Financial Summary & Health Plan Incentive Implementation

MY 2015 Financial Transparency Reports and MY 2016 Advanced Notice are currently being collected from health plans and will be posted here when available. VBP4P stakeholders will receive a notice when these documents are available.  Financial transparency reports will show the incentive payments made by each health plan participating in VBP4P and specify the payment methodology, adoption of the IHA common measure set, other incentive measures and use of the aggregated results. Health plans also provide advanced notice of their intentions for payment methodologies and budget for the upcoming measurement year.