Practice Improvement Program (PIP)
COVID-19 has significantly impacted the way care is delivered in the health care system. To ease reporting burden and allow financial support for the network, SFHP will be implementing the following for FY 2020-21:
- Decrease measure set from 28 total measures to 13 total measures, reduce performance requirements of Priority Five measures, maintain scoring methodology of non-Priority Five measures, and pay for reporting on new measures.
- Allow for the optional allocation of capitation withhold to Quality Improvement Projects (QIPs); funds to traditional PIP payments, 50% to Quality Improvement Projects.
The Practice Improvement Program (PIP) is San Francisco Health Plan’s pay-for-performance incentive program for Medi-Cal clinics and medical groups to achieve improvements in system and health outcomes.
Aligned with the Quadruple Aim:
- Improving patient experience
- Improving population health
- Reducing the per capita cost of health care
- Improving staff satisfaction
Provide Financial Incentives to Reward Improvement in the Provider Network
Program Eligibility Requirements
- Clinics or medical groups that directly contract with SFHP (see below for current participants)
- Assigned primary care medical home for 300+ SFHP members and/or HSF participants
- Comprehensive measurement across multiple domains
- Collaborative measure and program development
- Standardized measurement across all provider groups
- Financial incentives to motivate improvement
- Technical assistance that supports ongoing improvements
- Measures generally come from external sources, prioritizing HEDIS and NCQA metrics
- Factors taken into consideration are improvement potential, self- reporting feasibility, and how measure impacts SFHP (e.g. through auto-assignment)
- Measures support both DHCS electronic data requirements and comprehensiveness of coding
- Measures based on lowest performing CAHPS composite (currently Access)
- Measures support collaboration between various systems within which patients access care
- Funding is determined by Executive Team and Governing Board every September.
- PIP Advisory Committee provides input on measurement sets and advises on feasibility and alignment with other institutions.
- SFHP Governing Board and SFHP Quality Improvement Committee receive high-level updates at least yearly.
2020-21 Current Participants:
- Brown & Toland Physicians
- Chinese Community Health Care Association
- Hill Physicians Medical Group
- Jade Health Care Medical Group
- Marin City Health & Wellness Center
- Mission Neighborhood Health Center
- Native American Health Center
- North East Medical Services
- San Francisco Community Health Center
- SFHN Primary Care
- South of Market Health Center
- St. Anthony Medical Clinic
- UCSF Clinical Practice Group
- UCSF Health