How one of the largest Medi-Cal plans in California improves quality and care for members through partnerships and data sharing
Inland Empire Health Plan (IEHP) is one of the 10 largest Medicaid health plans and the largest not-for-profit Medicare-Medicaid plan in the country, serving more than 1.4 million residents in the Inland Empire and nearly 90 percent of Medi-Cal enrollees in the region.
IEHP’s relentless commitment to improving quality for their members and communities reflects their vision: “We will not rest until our communities enjoy optimal care and vibrant health.”
A key component of IEHP’s Hospital Pay for Performance (P4P) program, designed to reward hospitals for providing high-quality care, is active data sharing with Manifest MedEx (MX), a statewide nonprofit health data network. The incentives encourage hospitals to share important clinical data used to alert providers when patients have a hospital encounter and need effective post-discharge follow-up. This improves health outcomes and reduces readmissions, especially for vulnerable populations. Since 2018, IEHP has budgeted $124 million to the Hospital P4P program and has awarded more than $75 million for performance through Q2 2021.