​​​​​​Auto Assignment 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, Geographic Managed Care, and Regional delivery models (PDF) with a greater percentage of assigned mandatory enrollees (those who do not choose a MCP) 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 MCPs to Medi-Cal beneficiaries. The other two measures relate to continued commitment from MCPs to support safety net providers in their contracted networks. Beginning in January 2016, the Auto Assignment percentages may be adjusted up to 6% per county for plans who achieve or maintain a High-Performing Encounter Data Quality Grade. As of January 2015 AB-85 requires MCPs to default a certain threshold of its members, who do not choose a Primary Care Physician, to the County Public Hospital Health System. MCPs may lose up to 25% of their default allocation if it fails to meet the requirements of AB-85. DHCS convenes a stakeholder workgroup every year consisting of plan representatives, 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.

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Last modified date: 1/26/2023 2:59 PM