Medi-Cal Programs introduces the Performance Incentive Bonus Program

Blue Cross Medi-Cal Programs is pleased to announce a new program to reward our primary care physicians (PCPs).  Beginning in the second quarter of 1999, all eligible primary care physicians will have the opportunity to earn financial incentives based on specific program goals.

To be eligible for the program, PCPs must have at least 250 Blue Cross Medi-Cal members assigned to them under a fee-for-service contract. Providers who are on Blue Cross medical review during the evaluation period are ineligible for participation.

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There are a total of twenty performance incentive objectives.  Each PCP must demonstrate  conformance with specific scoring criteria to be eligible for incentive pool.  Note that the performance incentive objective payout could total as much as $3 per member per month.   For example, a PCP with 500 members could qualify for $18,000 annually.

Some of the performance incentive objective are:

  • Initial Health Assessments
  • Drug Formulary Utilization Rates
  • Electronic Claims Submission Rates
  • Over-the-Counter Drug Utilization Rates
  • Facility Review Audit Results
  • Extended Office Hours
  • Bright Futures Implementation

It is our goal to ensure that all primary care physicians have equal opportunity to maximize their potential in each objective.  For example, if you need the software to  maximize your score on electronic claims interface, or training on new member, immunization, and initial health report utilization, and initial health report utilization, please contact Blue Cross Medi-Cal for assistance.  The toll-free number is 1-800-227-3238.

Blue Cross Medi-Cal Programs looks forward to a successful implementation of the Performance Incentive Bonus Program.  Your efforts to increase the quality of care and services you provide to Blue Cross Medi-Cal members will be recognized and rewarded through this program.  We wish you every success in achieving these financial compensations.

Bright Futures* - A new resource for promoting health and well-being for children

The concept of Bright Futures is simple: provide appropriate health supervision   and care for all children.  Economic, societal, and demographic alterations to American families serve to compromise the family's ability to provide a nurturing environment for their children.  These changes have brought with them different causes of morbidity and mortality among children and adolescents.  Bright Futures is a system of three way collaboration: doctors, their patients under age 21, and the patient's family - all working together to optimize the delivery of health services to these young people.  The goal is to prevent the "new morbidities" from happening.

To receive Bright Futures materials and register for participation, just phone
BLUE CROSS MEDI-CAL at 1-800-227-3238.
We have made participation an integral element in the new Performance Incentive Bonus Program.

* Bright Futures is sponsored in part by: Maternal and Child Health Bureau, Health Resources and Services Administration.