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Health plans that participate in the AMP Commercial HMO and Medi-Cal Managed Care programs get a recommended incentive payment design that they can use to reward high-performing providers. Plans are encouraged to adopt the AMP incentive design to help focus attention and reduce administrative burden on providers trying to understand different incentive methodologies. However, each health plan may determine its own budget and methodology for calculating and distributing payments to provider organizations.

Alongside its committees, IHA designed the AMP Core incentive model to align with California-wide healthcare priorities. In particular, performance thresholds are aligned with Covered California, CalPERS, and the Department of Health Care Services, and the “Core 4” measures that are equity sensitive and appear in all measure sets are double weighted. The incentive design emphasizes quality, adjusted for total cost of care. Read more about the incentive model below.

Performance targets

Resources for previous design for MY 2022–2023

Incentive payment summaries and payment methodologies

IHA releases annual reports that detail the incentive payments distributed by participating health plans from the previous measurement year, as well as intended incentive payment methodologies for the upcoming measurement year.

The Summary of Health Plan Incentive Payment Report shows the incentive payments made and methodology used by each health plan participating in AMP Commercial HMO and Medi-Cal Managed Care.View the most recent reports:

The Advanced Notice Report provides transparency into if and how health plans intend to implement the standard IHA design for the upcoming measurement year. The report outlines if plans have any adaptations to the design elements. Future iterations will also share whether plans adopt any optional add-on elements to their design.

View the most recent report below: