26-985 Strengthening PPG Performance Standards and Oversight
Date: 09/03/26
Key updates to performance expectations, governance, and corrective action protocols
We have updated our Participating Physician Group (PPG) Performance Management processes to strengthen performance expectations, oversight practices and improvement protocols. These changes are intended to enhance accountability, clarify requirements and support consistent, high-quality performance across PPGs.
These enhancements provide clearer direction across critical performance areas, support more focused and effective Joint Operations Meeting (JOM) reviews, and help PPGs meet or exceed established performance benchmarks.
Summary of key process changes
- Implemented a formal Corrective Action Plan (CAP) policy and procedure to standardize how performance issues are addressed and resolved.
- Updated governance structure terminology, replacing "Delegation Oversight Committee" with "Delegated Provider Performance Governance," to better reflect current oversight practices.
Supporting documentation
Our provider operations manuals have been updated to reflect the recent changes to the PPG Performance Management processes. You can access the updated information in the Provider Library. Select the line of business, Provider Manual > Provider Oversight.
Have questions? Contact us
If you have questions regarding these performance management process changes, contact your Provider Engagement representative.
Provider Services
Line of business | Phone number | |
|---|---|---|
Ambetter from Health Net IFP Ambetter PPO | ||
Ambetter HMO | ||
Health Net Employer Group HMO, POS, & PPO | ||
Medicare (Individual & Employer Group) (Wellcare By Health Net) | ||
Medicare Supplement | ||
Medi-Cal (including CS and ECM providers) | N/A |
This information applies to Participating Physician Groups (PPGs).
For Medi-Cal, this information applies to Amador, Calaveras, Inyo, Los Angeles, Mono, Sacramento, San Joaquin, Stanislaus, Tulare and Tuolumne counties.