Provider Incentive Programs
HPSM offers five incentive programs that supplement standard reimbursement for primary care clinics, nursing facilities and select specialists. Four incentive programs are pay for performance (P4P) programs, or metrics-based incentives designed to help providers meet quality performance targets to improve outcomes and experience for HPSM members. The fifth program is a targeted rate increase for select specialists.
These incentives help us build and maintain a more diverse and well-resourced provider network.
Incentives for Primary Care Providers
- Care Gap Closure P4P offers providers real-time bonus payments through a web-based platform for individual efforts to close priority care gaps.
- Benchmark P4P is designed to improve outcomes by sharing data with HPSM primary care clinics on quality performance for their patients.
Incentives for Nursing Facilities
- Nursing Facility P4P is designed to improve quality of care by increasing member bed access, reducing inpatient and emergency department utilization, and improving care transitions.
- Community Discharge P4P incentivizes successful discharging of HPSM members from extended institutional stays to community settings where they remain for at least six months.
Incentives for Specialty Providers
- The Enhanced Specialty Rates program offers Medi-Cal allowable rates of 175% for certain Medi-Cal specialties to improve specialty care access and utilization.
For questions about our P4P incentives, email PSInquiries@hpsm.org.