Provider Incentives

Care-Based Incentives

The successful Care-Based Incentive (CBI) program for PCPs is in its seventh year. The CBI Program incorporates feedback from a variety of sources, such as provider surveys, Physician Advisory Group and other committees, evaluation of the CBI program, and input from the Alliance Board. The CBI Program incentivizes the Alliance's provider network with the following goals:

• Improve quality outcomes, as reflected in part by Healthcare Effectiveness Data and Information Set (HEDIS) scores
• Improve member experience
• Encourage delivery of high value care
• Improve patient access to primary care
• Encourage use of disease registries to address population health
• Encourage adoption of best-practice care guidelines as recommended by U.S. Preventive Services Task Force (USPSTF)
• Reduce disparities in quality or service delivery between groups of members and/or geographic regions

For more information on the CBI Program, please see Section 18 of the Alliance Provider Manual.

Specialty Care Incentives (SCI)

The Specialty Care Incentive (SCI) program compensates participating referral providers for offering Alliance Medi-Cal members access to certain specialty medical services. The program is designed to improve member access to specialty care services and encourage specialty care physician participation in the Alliance's Medi-Cal program.

For additional information on the SCI program, please see Section 18 of the Alliance Provider Manual.