Auto Assignment Incentive Program
The Auto-Assignment Incentive Program (AAIP) is a DHCS Incentive Program designed to reward MCPs with higher performance on select quality measures with additional Medi-Cal membership by assigning more members to better-performing MCPs. AAIP only applies to members who are not assigned to an MCP based on member choice, prior plan affiliation, family connection or alignment per the “Matching Plan Policy” for dual eligible members. In an ideal state, the vast majority of members would actively choose an MCP (based on MCPs’ outreach and engagement) and thus not be assigned to an MCP in AAIP.
The AAIP was initially implemented in the Medi-Cal managed care program in December 2005 (Year 1) in the Geographic Managed Care (GMC) and Two-MCP Model (2-Plan) counties. Performance on quality measures is used to determine how default enrollments are split between MCPs in each county. The quality performance 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 members and are from the DHCS Managed Care Accountability Set (MCAS). DHCS convenes a stakeholder workgroup every year, consisting of MCP representatives and DHCS staff, that reviews potential policy changes to the AAIP algorithm for the following year.
Historically, Safety Net Primary Care Provider (PCP) Assignment as detailed in AB 85 and Encounter Data Quality were part of AAIP. Going forward however, they are independently assessed and monitored by the program and are not factored into the methodology (unless a plan is out of compliance with AB 85 in which case the AAIP program will be adjusted per AB 85 requirements).
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