Auto Assignment Performance Incentive Program

The California Department of Health Care Services (DHCS) implemented the performance-based Auto Assignment Incentive Program in December 2005. This program rewards better performing plans in the Two Plan and Geographic Managed Care delivery models (PDF) with a greater percentage of assigned mandatory enrollees (those who do not choose a plan) based on an assessment of comparative plan performance on eight performance measures. Six measures are Healthcare Effectiveness Data and Information Set (HEDIS^®) measures related to the quality, access and timeliness of care provided by plans to Medi-Cal managed care plan members. The other two measures relate to plans’ continued commitment to safety net providers in their contracted networks. DHCS convenes a stakeholder workgroup every year consisting of plan representatives, advocates, and DHCS staff to review prior year results and recommend changes or additions to the performance measures included in the auto assignment algorithm for the following year.

Auto Assignment Program Overview (PDF)

Default Allocations for Enrollment Years 2006 to 2011 (PDF)   

2010 County Enrollment for Two-Plan and Geographic Managed Care Models (PDF)          

Related Links   

• California HealthCare Foundation's 2009 publication, Pay-for-Performance in the Medi-Cal Managed Care and Healthy Families Programs: Findings and Recommendations          
• The Commonwealth Fund’s 2007 publication, Pay-for-Performance in State Medicaid Programs: A Survey of State Medicaid Directors and Programs         
• California HealthCare Foundation's 2006 publication, Putting Quality to Work: Rewarding Plan Performance in Medi-Cal Managed Care    
• Center for Health Strategies, Inc.’s 2005 publication, Managed Care Organizations (MCO), Primary Care Case Management (PCCM), Behavioral Health Organization (BHO) and Fee-For-Service (FFS) Descriptions of Selected Performance Incentive Programs (PDF)    

Contact information

Athena Chapman, Chief
Program Monitoring and Medical Policy Branch
Medi-Cal Managed Care Division 
Athena.Chapman@dhcs.ca.gov