Partnership HealthPlan of California is deeply committed to ensure that all our members receive high quality health care services and achieve excellent and equitable health outcomes. To make sure this happens, Partnership has five areas of focus that are reviewed by physicians in the community, Partnership's board of directors and the Department of Health Care Services (DHCS). The five areas of focus include:
Quality Strategic Plan
Quality Tactical Plan
Quality Improvement Program Description
Quality Improvement Workplan
Annual Quality Improvement Evaluation
Public Reporting of quality data is a tool used by Centers for Medicaid and Medicare Services (CMS), DHCS, and some health plans to help push quality improvement forward. Research on this topic shows the main influence for improved quality is not patient choice based on the quality of a physician or a medical clinic's reputation, instead improved quality is based on clinical providers spending more leadership and organizational attention to quality improvement, based on concern over their public reputation.
Public reporting of quality data also works closely with other interventions to improve quality, such as pay-for-performance programs, provider educational offerings on quality topics, individual practice coaching, and leadership engagement activities. Partnership's pay-for-performance program (the PCP QIP) includes a core measure set that is well-established, stable and is a tool used for summarizing the quality outcomes of our primary care providers. The data collection and feedback process has been refined for over two decades and includes multiple teams of people both within and outside of Partnership.
For this reason, Partnership presents the scoring results of the PCP Quality Incentive Program (QIP) as a window into the quality outcomes achieved by our PCP network providing care for our members. Partnership knows there are other features of quality not represented in the PCP QIP such as the quality of the PCP facility, aspects of access in the office such as phone response time, waiting time in the waiting room, and the diagnostic expertise of the clinicians. Nonetheless, this measure set includes many areas of quality and is a good starting point for evaluating the quality of care provided by Partnership's PCP network.
County level performance scores are provided using 2022 PCP QIP performance data and are displayed for each county by each PCP site.
Partnership performance rates utilize a quality star rating representing a range of quality scores for the selected QIP measurement year. Each PCP site is given a rating between one and five stars, with five stars reflecting the highest level of quality rating. PCP sites and counties participating in the PCP QIP are listed with the following information:
Final QIP score for the measurement year
Number of assigned members in QIP denominators
PCP site's rank by county
Subregion Total and Planwide Total are included for rank comparison
2023 Partnership plan wide results show Partnership's weighted average performance as 66.44%. Plan wide scores for the past two years were 67.21% (2023) and 68.60% (2022).
