Central Coast Primary Care Providers Recognized, Rewarded for Quality of Care

Local Medi-Cal health plan receives award for quality, health equity from State

CenCal Health provider network performed in top 5% of Medicaid plans nationally

for four healthcare quality measures, in top 10% for additional five

On October 18, CenCal Health – the Medi-Cal managed care plan for Santa Barbara and San Luis Obispo counties – received a 2023 quality award from the California Department of Health Care Services (DHCS). Highlighting the work and accomplishments of healthcare providers in the plan’s network, the Certificate of Achievement was presented to CenCal Health for its notable advancements in various quality and health equity strategies, which support DHCS’ Bold Goals for 2025. The award was presented to CenCal Health’s quality team during the 2023 Quality Conference, held in Sacramento and hosted by DHCS and the Health Services Advisory Group for Medi-Cal Managed Care Plans. Accepting the Certificate of Achievement were members of CenCal Health’s quality team (left to right) Health Promotion Educators Roxana McBurney, MPH, CHES and Zena Chafi-Aldwaik, MPH, CHES; Quality Measurement Supervisor Chelsee Elliott, and Population Health Specialist Karina Negrete.

“This award is meaningful to us because it demonstrates the commitment and dedication of local physicians and safety-net clinics, who live the mission every day,” said CenCal Health CEO Marina Owen. “As a local health plan, we value compassionate service and improvement. So, ‘our work continues’ until every member receives equitable access to preventive care and achieves optimal health.”

CenCal Health partners with over 1,500 local physicians, hospitals and other providers in delivering patient care to nearly 230,000 members. Medi-Cal is the name of California’s Medicaid benefits program; the federal government administers Medicaid.

Also in October, CenCal Health distributed nearly $4 million in quarterly payments to participating primary care providers (PCPs) through the Quality Care Incentive Program (QCIP). Launched in March 2022, QCIP is a value-based incentive program that directly rewards plan providers who deliver exceptional medical care in their community, emphasizing the clinical priorities of significance to Medi-Cal members, such as diabetes and asthma care, breast cancer and cervical cancer screenings, and child and adolescent well-care visits. To promote health equity, QCIP payments are also tied to the diversity of member patients managed by each PCP; as such, payments increase to reflect the proportion of members of greater clinical complexity, for example, the aged or those disabled.

The most recent QCIP payout was distributed to 88 PCPs on the Central Coast – recipients can be single physician providers or physician groups. Among this group of local QCIP participants, the top performing physician is pediatrician Jeffrey S. Kaplan, MD, in practice in Santa Maria for over two decades. Other top performers include Pediatric Medical Group of Santa Maria; Santa Barbara pediatrician Augusto Castaneda, MD; Sansum Clinic – State Street Family Medicine; and the Advanced Primary Care unit of Community Health Centers of the Central Coast. By the end of 2023, over $15.5 million in QCIP payments will have been paid out to participating primary care providers on the Central Coast.

“Thank you to our PCPs for their ongoing achievements and support. This pay-for-performance initiative not only rewards equitable, quality care by our top providers but it also helps to increase access to care for Medi-Cal members on the Central Coast,” said Owen.

In addition, CenCal Health recently released the results of its 2022 Quality of Care Compliance Audit.  This annual healthcare assessment is based on the widely used performance tool Healthcare Effectiveness Data and Information Set or HEDIS®, which evaluated the effectiveness of care, access and availability, and other important aspects of care and service for the period ending December 31, 2022. HEDIS measures performance in health care where improvements can make a meaningful difference in people’s lives. CenCal Health’s HEDIS measurements are independently audited and reported annually to the National Committee for Quality Assurance to validate the quality of care rendered by CenCal Health’s providers.

More information on CenCal Health is available at cencalhealth.org.

About CenCal Health

CenCal Health is the local Medi-Cal health plan that partners with over 1,500 local physicians, hospitals, and other providers in delivering health care services to nearly 230,000 members in its two-county service area – one in three residents of Santa Barbara County and one in four residents of San Luis Obispo County. Marking 40 years of serving the most vulnerable, CenCal Health prioritizes cultivating community partnerships; advancing quality and health equity; expanding its service role and reach in the community; and organizing for impact and effectiveness. With a vision to be a trusted leader in advancing health equity so that the communities we serve thrive and achieve optimal health, CenCal Health invites the public to review its 2023-2025 Strategic Plan at cencalhealth.org/strategicplan.

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Media Contact: Sheri Mobley  (213) 509-9816   sheri@seamlesspr.com

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