July 12, 2022
Effective July 1, 2022, the California Department of Health Care Services (DHCS) has sunset the Proposition 56 funded Medi-Cal Value-Based Payments program. The program incentivized providers for meeting specific measures and benchmarks that improve the quality of care provided to Medi-Cal beneficiaries.
While the California Medical Association (CMA) had urged DHCS to continue this program in some form, the program was scheduled for elimination at the end of this past fiscal year. The Prop. 56-funded Medi-Cal supplemental payments that apply to a set of 23 primary care focused CPT codes and family planning services will not be affected and were made permanent as part of the 2021-22 state budget.
CMA and the physicians of California remain committed to improving the quality of care in Medi-Cal and believe that value-based payments are a valuable tool for incentivizing additional outreach, resources and efforts to improve access to quality care for our most vulnerable residents.
CMA stands ready to work with DHCS and other health care stakeholders to promote innovative payment strategies that promote health care equity, especially amongst children, and access to care for Medi-Cal beneficiaries.