Directed Payments DPH Quality Incentive Program

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Beginning with the July 1, 2017, rating period, the Department will implement a managed care DPH QIP. The Department will direct MCPs to make QIP payments tied to performance on designated performance metrics in four strategic categories: primary care, specialty care, inpatient care, and resource utilization. The QIP payments will be linked to delivery of services under the MCP contracts and increase the amount of funding tied to quality outcomes. To receive QIP payments the DPH and UC systems must achieve specified improvement targets, which grow more difficult through year-over-year improvement or sustained high performance requirements. The total funding available for the QIP payments will be limited to a predetermined amount (pool).

Program Authorities

Policies

QPL-18-001 QIP PY 1 Reporting.pdf
QIP PY 1 Certification Form.pdf
QPL-18-002 Minimum Number of Cases.pdf (SUPERSEDED BY QPL-19-001; Please review QPL-19-001)
QIP Data Integrity Policy.pdf
QPL-19-001 Minimum Reporting Requirements.pdf (SUPERSEDES QPL-18-002)
QPL-19-002 QIP Measure Set PY 3 - This QIP Policy Letter (QPL) informs all QIP Entities of the updated measure set and stratification requirements for Program Year (PY) 3 (July 1, 2019 – June 30, 2020).
QPL-19-003 PY 2 Reporting- This QIP Policy Letter (QPL) provides Program Year (PY) 2 reporting instructions for the Quality Incentive Pool (QIP) program.
QPL-20-001 QIP PY 3 Reporting and Payment Changes - This QIP Policy Letter (QPL) informs all QIP Designated Public Hospitals and Health Systems (DPHs) of Program Year (PY) 3 (July 1, 2019 – June 30, 2020) reporting and payment changes for the Quality Incentive Pool (QIP) program.

Data Sharing

Data Sharing for the SFY 17-18 QIP Memorandum (9/10/2018)

QIP Value Sets by Measure for MCPs for DPH Reporting (9/18/2018)
QIP Reporting Manual PY1: for general guidance only (9/17/18)

QIP_PY2_Value Sets_by_Measure_for_MCPs_for_DPH_Reporting_04_04_2019.xls
QIP DATA SHARING FILE TEMPLATEv1.xls–This template is based on Inland Empire Health Plan’s (IEHP) PRIME Data Sharing File Template to provide IEHP’s County partners with PRIME data.
QIP_PY3_Value Sets_by_Measure_for_MCPs_for_DPH_Reporting
QIP-PY3.5-Value-Sets-by-Measure-for-MCPs-for-DPH-Reporting
QPL-20-002 Data Sharing - This QIP Policy Letter (QPL) informs Medi-Cal Managed Care Health Plans (MCPs) of data sharing requirements associated with the Quality Incentive Pool (QIP) directed payment program.

QIP Evaluations

Contact Us

For more information, please contact the QIP team at qip@dhcs.ca.gov.

Last modified date: 12/18/2020 2:29 PM

​​​​​Directed Payments DPH Quality Incentive Program