Proposition 56 Proposals 

The Department of Health Care Services (DHCS) is requesting public comment on proposals in the Governor’s budget relating to the Value Based Payment (VBP) Program, developmental screenings, and trauma screenings. Comments should be submitted to DHCS_PMMB@dhcs.ca.gov by March 22, 2019; questions should be submitted to this same inbox. DHCS will convene two webinars to discuss the content of these proposals; additional information about the webinars will be released as it becomes available.

• For FY 19-20 the Governor’s Budget proposes a VBP through Medi-Cal managed care health plans (MCPs) that will provide incentive payments to providers for meeting specific measures aimed at improving care for certain high-cost or high-need populations. These risk-based incentive payments will be targeted at physicians that meet specific achievement on metrics targeting areas such as behavioral health integration; chronic disease management; prenatal/post-partum care; and early childhood prevention. This program is funded with $180 M in Proposition 56 funds - $360 M in total funds, annually. It will be implemented for at least three years in the managed care delivery system.

• VBP Proposal

• VBP Proposal Comments Grid

• For Fiscal Year (FY) 19-20 the Governor’s Budget proposes to use $60 Million (50% Proposition 56 Funds/50% Federal Funds) to support developmental screenings on an ongoing basis for all children with full-scope coverage in Medi-Cal. These screenings will be billed and reimbursed in both the managed care and fee-for-service delivery systems. These payments will be in addition to the amounts paid for the office visit that accompanies the screening in fee-for-service scenarios or capitation paid by Medi-Cal managed care health plans (MCPs).

• Developmental Screenings Proposal

• For Fiscal Year (FY) 19-20 the Governor’s Budget proposes to use $45 million (50% Proposition 56 Funds/50% Federal Funds) to support the first step in trauma informed care which is trauma screenings for all children and adults with full-scope coverage in Medi-Cal. These screenings will be billed and reimbursed in both the managed care and fee-for-service delivery systems. These payments will be in addition to the amounts paid for the office visit that accompanies the screening in fee-for-service scenarios or capitation paid by Medi-Cal managed care health plans (MCPs).

• Trauma Screenings Proposal

Webinar Presentations: 

•  Developmental and Trauma Screenings Webinar- March 12, 2019

• Value Based Payment Program Performance Measures- March 19, 2019