Private Hospital Directed Payment Program
Back to Directed Payments
Beginning with the State Fiscal Year (SFY) 2017-18 rating period, the Department will direct Managed Care Plans (MCPs) to reimburse private hospitals as defined in WIC 14169.51, based on actual utilization of contracted services. The enhanced payment is contingent upon hospitals providing adequate access to service, including primary, specialty, and inpatient (both tertiary and quaternary) care. 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 dollar increment. The total funding available for the enhanced contracted payments will be limited to a predetermined amount (pool).
MCPs, for all managed care questions regarding this program, please reach out to the Hospital Directed Payment team PlanDP@dhcs.ca.gov.
Providers, for all managed care questions regarding this program, please reach out to the Hospital Directed Payment team PrivateDP@dhcs.ca.gov.
CY 2024 (January 1, 2024 – December 31, 2024)
CY 2023 (January 1, 2023 – December 31, 2023)
- CY 2023 Private Hospital Directed Payment Approval Package
- CY 2023 Private Hospital Directed Payment Evaluation Report
CY 2022 (January 1, 2022 – December 31, 2022)
- CY 2022 Private Hospital Directed Payment Preprint Approval Letter
- CY 2022 Private Hospital Directed Payment Preprint
- CY 2022 Private Hospital Directed Payment Evaluation Report
CY 2021 (January 1, 2021 – December 31, 2021)
- CY 2021 Private Hospital Directed Payment Preprint Approval Letter
- CY 2021 Private Hospital Directed Payment Preprint
- CY 2021 Private Hospital Directed Payment Evaluation Report
Bridge Period (July 1, 2019 – December 31, 2020)
- Bridge Period July 1, 2019 – Dec 31, 2020 Private Hospital Directed Payment Approval Letter
- Bridge Period July 1, 2019 – Dec 31, 2020 Private Hospital Directed Payment Preprint
- Bridge Period Private Hospital Directed Payment Evaluation
State Fiscal Year 2018/2019 (July 1, 2018 – June 30, 2019)
- SFY 2018/2019 Directed Payments Private Hospital Preprint
- SFY 2018/2019 Private Hospital Direct Payment Approval Letter
- SFY 2018/2019 Directed Payments Evaluation
State Fiscal Year 2017/2018 (July 1, 2017 – June 30, 2018)
- SFY 2017/2018 Directed Payments Private Hospital Preprint
- SFY 2017/2018 Private Hospital Direct Payment Approval Letter
- SFY 2017/2018 Directed Payments Evaluation