Beginning with the State Fiscal Year (SFY) 2017-18 rating period, the Department will direct Managed Care Plans (MCPs) to reimburse California's 21 DPHs for network contracted services delivered by DPH systems, enhanced by either a uniform percentage (“CA DPH Capitated Uniform") or dollar increment based (“DPH FFS Uniform") on actual utilization of network contracted services. The state will evaluate the extent to which enhanced payments are achieving the goals identified. These may only apply to certain managed care categories of aid. The payments will be enhanced by either a uniform percentage or a dollar increment. The total funding available for the enhanced network contracted payments will be limited to a predetermined amount (pool).
MCPs, for any managed care questions regarding this program, please reach out to the Hospital Directed Payment team
PlanDP@dhcs.ca.gov.
Providers, for any managed care questions regarding this program, please reach out to the Hospital Directed Payment team at
PublicDP@dhcs.ca.gov.
Designated Public Hospital Capitated Payments
