What's New for the Care-Based Incentive Program

What's New for CBI 2025

The Central California Alliance for Health CBI program is comprised of a set of measures to encourage preventive health services and connect Medi-Cal members with their primary care providers (PCPs). The program offers financial incentives and technical assistance for providers to help members self-manage their care and reduce proximal health care costs. The CBI program pays qualifying contracted provider sites, including family practice, pediatrics and internal medicine. Provider incentives are broken into:

• Programmatic measures which are paid annually based on rate of performance in each measure.
• Fee-for-service (FFS) measures which are paid quarterly when a specific service is performed, or a measure is achieved.

New Programmatic Measures:

The following measures were moved from exploratory to programmatic measures:

• Chlamydia Screening in Women: The percentage of women 16-24 years of age who are identified as sexually active and had at least one test for chlamydia during the measurement year.
• Colorectal Cancer Screening: The percentage of members 45–75 years of age who had appropriate screening for colorectal cancer.
• Well-Child Visits for Age 15 Months–30 Months: The percentage of members 30 months of age who had two or more well-child visits with a PCP between the child’s 15-month birthday plus one day and the 30-month birthday.

Measure Changes:

• Diabetic HbA1c Poor Control >9.0% changed to Diabetic Poor Control >9%. The measure was modified to review the most recent glycemic status received through hemoglobin A1c [HbA1c] or glucose management indicator [GMI].
• Post-Discharge Care: The measure was updated to:
  • Accept follow-up care by specialists.
  • Exclude members admitted to a Skilled Nursing Facility (SNF) on the same day of discharge.

Retired Measures:

• Health Equity: Child and Adolescent Well-Care Visit
• Performance Improvement Measure