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Directed Payments DPH Quality Incentive Program

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).

SFY 2017/2018 Directed Payments DPH QIP Preprint
SFY 2017/2018 Uniform Increase Designated Public Hospital Quality Incentive Program Direct Payment Approval Letter
SFY 2018/2019 Directed Payments DPH QIP Preprint
SFY 2018/2019 Uniform Increase Designated Public Hospital Quality Incentive Program Direct Payment Approval Letter
Hospital Directed Payment Definition SFY 2017-2018 and SFY 2018-2019
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)

PY 1 Reporting

QPL-18-002 Minimum Number of Cases.pdf (SUPERSEDED BY QPL-19-001; Please review QPL-19-001)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)
Data Sharing for PY 2

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.

Contact Us

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

Last modified on: 5/7/2019 1:23 PM