Quality Incentive Pool (QIP) Program Data PRIME transition Measures (Year 3.5)

The Department of Health Care Services implemented a managed care QIP in Designated Public Hospitals (DPH) beginning with the July 1, 2017, rating period. The Department directed Managed Care Plans to make QIP payments based on performance metrics in four strategic categories: primary care, specialty care, inpatient care, and resource utilization. The datasets include self-reported data on these metrics from DPH annual reports. PY3.5 marked changes to the QIP program incorporating the District and Municipal Public Hospitals (DMPHs) as participating entities and adding Public Hospital Redesign and Incentives in Medi-Cal (PRIME) measures and funding into QIP. With the PRIME program, part of the Medi-Cal 2020 1115 Demonstration, ending June 30, 2020, PRIME measures and funding were added to QIP to maintain and continue the momentum achieved with DPHs and DMPHs on improvements in the quality of care delivered to Medi-Cal beneficiaries. To view prior PRIME data please go to this website (https://data.chhs.ca.gov/dataset/public-hospital-redesign-and-incentives-in-medi-cal-prime-program-dy11-dy13-data).