News
23-040 Initial Health Assessment Incentive in 2023 Applies to Physicians and Clinics Only
Date: 01/06/23
Clarification to provider update 22-1078
Provider update 22-1078, See What’s New with IHA and HIF, distributed on December 19, 2022, incorrectly implied that we are incentivizing participating physician groups (PPGs) for completed Initial Health Assessments (IHAs) for new Medi-Cal members within 120 days for 2023.
Please note, the IHA incentive applies to individual physicians and clinics only and does not apply to PPGs.
Refer to the information in this provider update going forward about the IHA incentive for physicians and clinics.
What’s new in 2023
- The Individual Health Education Behavior Assessment (IHEBA) and the Staying Healthy Assessment (SHA) forms are no longer required.
- Initial Health Assessment is now called Initial Health Appointment (IHA).
Individual physicians and clinics! Get paid when you complete the IHA
For 2023, we are incentivizing IHA as a new measure for physicians and clinics.
Physicians and clinics can earn an incentive when you complete an IHA for new Medi-Cal members within 120 days.
- An IHA must be completed for all newly enrolled Medi-Cal members within 120 days of enrollment.
- We will continue auditing the IHAs completed within 120 days of member enrollment in your upcoming facility site review and medical record.
Stay tuned for more information, including rates, in early 2023.
Help your patients complete their HIF and act on positive screens
The Plan will implement additional outreach to increase Health Information Form (HIF) submissions, but we need your help!
While your patient is in your office to complete their IHA, help them complete and submit their HIF.
What does HIF do for my patient
The HIF will help identify any positive screens, extra needs or services your patient may require, such as transportation, access to food, their self-perception of health, and impairments related to activities of daily and independent living.
We will incorporate the responses from these forms into our risk stratification algorithm for provision of timely services and supports.
Where can we get the HIF
HIF forms can be downloaded at member forms.
Once completed, keep a copy in the member’s chart and send the form to:
Medi-Cal Care Management
4191 E. Commerce Way
Sacramento, CA 95834
Keep a look out for future updates from us!
- We are working on a process for bidirectional data sharing of screenings and assessments results.
- We are working on a process to share our risk stratification, segmentation and tiering with providers.
Additional information
If you have questions about: |
Visit or contact: |
|---|---|
How to complete the IHA |
www.healthnet.com/content/healthnet/en_us/providers/working-with-hn/quality_imp_tools.html under Initial Health Assessment |
How to help your patient complete the HIF |
Member services using the number on the back of the member ID card for additional support. |
For all other questions, contact CalViva Health at 888-893-1569.
This information applies to Physicians and Participating Physician Groups (PPGs).
This information applies to Medi-Cal in Fresno, Kings and Madera counties.