As an AMP participant, you’ll be in good company. Leading California plans and providers participate in one or more of our AMP programs.
As the oldest and largest AMP program, AMP Commercial HMO includes eleven California health plans and over 200 provider organizations. Together, they care for close to 10 million Californians and cover 95 percent of the state’s commercial HMO enrollment.
AMP Commercial HMO tracks the quality, cost, and resource use measures that the industry agrees are most important. As an AMP Commercial HMO participant, you’re measured on a common measure set that reduces redundancy and helps Californians get better care.
AMP Commercial ACO tracks the quality, cost, resource use, patient experience, and advancing care measures that matter most to ACO purchasers, payers, and providers. The measures focus on the top 11 out of 12 clinical priority areas that contribute to the highest healthcare spending as identified by Catalyst for Payment Reform.
When you join AMP Commercial ACO, you’ll be aligned with regional and national efforts to improve care quality and value. In fact, the program includes almost 75% of the Core Quality Measures Collaborative’s (CQMC) ACO core measure set—the leading effort to coordinate national measurement priorities. The alignment streamlines reporting, especially for AMP participants with a national presence. The result is a singular focus on making healthcare work better for everyone in California and beyond.
Many California Medicare Advantage plans lack sufficient enrollment to accurately measure provider performance and target improvement efforts on their own. AMP Medicare Advantage solves this challenge by aggregating performance data across participating plans to produce more robust results. These insights improve measurement reliability and validity and streamline reporting for physicians.
Our program mirrors the measures and methodologies that the Centers for Medicare & Medicaid Services (CMS) uses for its star ratings system. Specifically, we use 14 clinical measures from the star ratings system. As a participant in AMP Medicare Advantage, you receive targeted performance information that supports eligibility for CMS performance incentives. The insights also help plans identify and reward high-performing provider organizations.
Overall ratings among participating provider organizations:
Today, 85% of Medi-Cal enrollees receive care through managed care plans, and Medi-Cal plans are shifting to value-based incentive payments. At the same time, providers are increasingly caring for both publicly and commercially enrolled patients. To advance high-value care for all, aligned and consistent performance measurement is critical.
AMP Medi-Cal Managed Care meets these needs with a performance measurement program that helps improve care for your most vulnerable patient populations and is aligned with measurement for other populations. Measures include comprehensive diabetes care, provider communication, emergency department visits, and inpatient utilization. The program builds on work that IHA began several years ago to increase measure alignment across Medi-Cal plans.