Central California Alliance For Health


2018 Care Based Incentives

For complete information on the Care Based Incentives (CBI) Program, please see Section 18 of the Alliance Provider Manual.

What's New for 2018

New Fee-For-Service (FFS) Measure

Buprenorphine License: Payment for this measure is based on providers obtaining an X-License through the Drug Enforcement Agency (DEA). The Alliance will pay $1,000 for each CBI group that the X-licensed clinician practices under. Non-physician medical practitioners (NPMPs) must submit their X-license and that of their supervising primary care physician to be eligible for incentive payment.

Programmatic Measure Changes

Program Change: Due to new guidelines from the State of California, the 2018 CBI Program has shifted to primarily programmatic measures.

Measure Change: 90 Day Readmissions has changed to 30 Day Readmissions. Payment is based on the number of readmissions per 1,000 eligible members per year.

Measure Change: Generic Prescriptions is now titled Formulary Adherence. No changes were made to how the measure is calculated. Please see the Technical Resources document on the CBI Resources page of the Alliance provider website for a list of preferred prescriptions.

Introducing Provisionary Measures

The following measures will not qualify for payment in 2018; they will be monitored and considered for payment in CBI 2019. Providers will receive quarterly rates and can monitor their performance in preparation for payment in 2019.

Clinical Depression Screening
Clinical Depression Follow Up Care
Adolescent Immunizations
Formulary Medication Utilization: Basaglar
Formulary Medication Utilization: Air Duo

Discontinued Measures

Due to the new guidelines form the State of California the following measures have been removed from the 2018 CBI Program:

Electronic Claims Submittal
Electronic Referrals Submittal
Extended Office Hours
Advanced Care Planning

Asthma Action Plans have also been removed from the 2018 CBI Program. However, the Alliance encourages the use of the forms with your patients. The forms are now located in the Forms Library.


Members | Miembros | Cov Tswvcuab | Providers | Community | About Us | 2018 Central California Alliance for Health®