CALIFORNIA STRENGTHENS ACCOUNTABILITY IN MEDI-CAL QUALITY RATINGS
DHCS' Quality Improvement Strategies Are Driving Measurable Progress Across Medi-Cal
SACRAMENTO — The California Department of Health Care Services (DHCS) today released the 2024 quality ratings for Medi-Cal managed care plans (MCP) and county behavioral health plans (BHP), highlighting measurable improvements in care quality, expanded oversight, and a deepening commitment to health equity across the state's Medi-Cal delivery system.
This is the fourth year of MCP ratings and the third for BHPs. The ratings are based on performance against the Managed Care Accountability Set and Behavioral Health Accountability Set measures for services delivered from January to December 2024. These measures evaluate how well plans deliver high-quality, equitable care across key domains, such as preventive services, behavioral health, maternal health, and chronic disease management. They also inform DHCS' oversight of managed care and county behavioral health systems, supporting enforcement actions, such as monetary sanctions and Corrective Action Plans (CAP), when performance standards are not met. Among the key findings:
- Across the state, performance improved in all areas measured. Several key areas, like developmental screenings, lead testing, and follow-up care, each improved by at least 5 percentage points. Follow-up after mental health visits improved by more than 13 percentage points.
- 14 of 22 MCPs received monetary sanctions for failing to meet and exceed DHCS-established Minimum Performance Levels, a notable improvement from 2023, when 18 plans were sanctioned.
- The total sanction amount dropped by more than 50 percent, from $3.1 million to $1.5 million, reflecting meaningful gains in the provision of early childhood screenings, well-child visits, and preventive dental services.
BHPs are being held accountable through CAPs, with 10 of 56 Mental Health Plans and 29 of 38 Drug Medi-Cal Organized Delivery System plans receiving CAPs based on performance calculated using Medi-Cal Connect, DHCS' statewide data analytics platform.
“These results reflect our shared commitment to advancing quality and equity across the Medi-Cal delivery system," said DHCS Director Michelle Baass. “We are seeing real progress in areas like children's preventive care, dental services, and behavioral health performance. We know there's more work to do, and we're holding ourselves and our partners accountable every step of the way."
DHCS is transitioning to performance-based oversight with a strong emphasis on equity and data-driven progress. For example, in 2025, the Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) Access, Reform and Outcomes Incentive Program began offering payments to BHPs that demonstrate progress on key behavioral health measures.
“This isn't just about numbers; it's about making real, positive changes in the way care is delivered," said Dr. Palav Babaria, Chief Quality and Medical Officer and Deputy Director of Quality and Population Health Management. “We're doing it in partnership with our MCP and BHP partners, and I'm incredibly proud of the progress we've made so far. Every step we take is about building a Medi-Cal health care delivery system that works for all members."
Dr. Babaria added, “By leveraging data, aligning incentives, and listening to the voices of Medi-Cal members, we're creating a system that not only measures performance, but also supports continuous learning and improvement. Our goal is to ensure that every Californian, regardless of geography or background, has access to high-quality, coordinated care."
Updated fact sheets, enforcement reports, and sanction letters are available on the Medi-Cal Managed Care Monitoring page.