Incentives for Primary Care Providers
Care Gap Pay-for-Performance Incentive
HPSM’s Care Gap Pay-for-Performance Incentive (“Care Gap P4P”) provides a web-based platform summarizing health needs for HPSM patients, enabling providers timely insight to efficiently recognize and close care gaps. This platform offers real-time bonus payments rewarding providers for individual actions (e.g. scheduling appointments) to close priority care gaps through well visits, initial health appointments, preventive screenings, immunizations, and more. Enrolled providers gain access to programmatic support through HPSM and our administrative partner, Stellar Health.
Contracted primary care clinics may elect to participate in Care Gap P4P instead of HPSM’s Benchmark Pay-for-Performance Incentive “Benchmark P4P”. Providers may only participate in one primary care incentive program at a time, i.e., providers enrolled in Care Gap P4P are not eligible for simultaneous participation in Benchmark P4P.
To enroll in Care Gap P4P, providers first participate in an onboarding call with the Stellar Health team. Please contact PSInquiries@hpsm.org or your Stellar Health representative if you would like more information.
Benchmark Pay-for-Performance Incentive
HPSM's Benchmark Pay-for-Performance Incentive (“Benchmark P4P”) is designed to improve outcomes by offering bonus payments to in-network primary care providers meeting performance targets for select quality metrics. HPSM shares assigned patient
population data with each primary care clinic. Providers utilize the eReports portal to access these data, obtaining information
to understand both individual patient care needs and current performance regarding population health metrics.
Contracted primary care clinics may elect to participate in Care Gap P4P instead of Benchmark P4P. Providers may only participate in one primary care incentive program at a time, i.e., providers enrolled in Care Gap P4P are not eligible for simultaneous participation in Benchmark P4P.
Current Benchmark P4P Materials
Program Guidelines include clinic eligibility, quality metric technical specifications, and deadlines.
- Medi-Cal 2024 Benchmark P4P and Capitation Bonuses Program Guidelines
- CareAdvantage 2024 Benchmark P4P Program Guidelines
- MY2024 P4P Attestation Template
- eReports User Guide - Primary Care
- Avoidable ED Visit Codes
- Claims and Encounter Data Submission
- Medi-Cal 2020 Primary Care Benchmark P4P Program Webinar (recorded December 6, 2019) VIDEO | SLIDES
- CareAdvantage 2020 Primary Care P4P Program Webinar (recorded December 13, 2019)
VIDEO | SLIDES