Improving Quality

Practice Improvement Program (PIP)

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.

Primary Objectives

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
Guiding Principles
  • 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

Measure Domains

Clinical Quality
  • 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)
Data Quality
  • Measures support both DHCS electronic data requirements and comprehensiveness of coding
Patient Experience
  • Measures based on lowest performing CAHPS composite (currently Access)
Systems Improvement
  • 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.
2024 Current Participants:
  • Brown & Toland Physicians
  • Chinese Community Health Care Association
  • HealthRIGHT360
  • Hill Physicians Medical Group
  • Jade Health Care Medical Group
  • Lyon-Martin Community Health Services
  • 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
PIP 2024 Program Guide

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