Primary care providers recognized, rewarded for quality of care

CenCal Health’s Quality Care Incentive Program is a pay-for-performance program that directly rewards plan providers who deliver exceptional medical care to CenCal Health patients. Since the program’s launch in March 2022, CenCal Health has distributed $27.0 million to 98 unique Central Coast primary care providers.

Implemented by CenCal Health, the Quality Care Incentive Program provides financial incentives to primary care providers to motivate primary care practice transformation to sustainably ensure delivery of high-quality, evidence-based, preventive care and treatment. Emphasizing the clinical priorities of significance to Medi-Cal members, the goal of the Quality Care Incentive Program is to ultimately reach better health outcomes for Medi-Cal members and uphold a more efficient health care system.

Members due for clinically recommended aspects of care are identified to further assist primary care providers to support their patients needing diabetes and asthma care management, breast cancer and cervical cancer screenings, child and adolescent preventive care, and more. The program's payments are also tied to the diversity of member patients managed by each primary care provider; as such, payments increase to reflect the proportion of members of greater clinical complexity, for example, the aged or those disabled.  

Effective April 2024, the program's payment calculations will incorporate two more clinically essential aspects of care that warrant significant improvement. These additions include seasonal flu vaccination for two-year-olds and human papillomavirus (HPV) vaccination for adolescents. Payments are distributed quarterly.

CenCal Health Board member Dr. René Bravo of Bravo Pediatrics (center) congratulates the exemplary achievement of pediatric physicians Dr. Augusto Castaneda (left) and Dr. Jeffrey Kaplan (right), who were among the top performing physicians to receive incentive payouts through the Quality Care Incentive Program in 2023.

Practicing pediatric medicine in Santa Maria for over two decades, Dr. Kaplan has been a standout performer since the innovative Quality Care Incentive Program was launched in March 2022.