What's new for the 2026 Care-Based Incentive Program?

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 measure

The Controlling High Blood Pressure measure moved from exploratory to programmatic and measures members 18-85 years of age who had a diagnosis of hypertension (HTN) and whose blood pressure (BP) was adequately controlled (<140/90 mm Hg) during the measurement year.

The BP reading must occur on or after the date of the second HTN diagnosis.

Measure changes

• The Application of Dental Fluoride Varnish measure now requires at least two topical fluoride applications by the end of the CBI program year and co-located dental practices at Federally Qualified Health Centers (FQHCs) can now submit dental data via the Data Submission Tool.
• The Breast Cancer Screening measure now measures members 40-74 years of age who were recommended for routine breast cancer screening and had a mammogram to screen for breast cancer. The measure also includes gender-affirming codes that can be submitted via the Data Submission Tool.
• The Child and Adolescent Well-Care Visits (Three to 21 Years), Well-Child Visits in the First 15 Months, and Well-Child Visits for Age 15 Months-30 Months of Life measures removed telehealth visits from each of the measure numerators.
• The Immunizations: Adolescents measure now includes the pentavalent meningococcal vaccine for numerator compliance and the age for MCV now begins at 10 years of age.
• The Social Determinants of Health (SDOH) ICD-10 Z Code Submission fee-for-service measure now accepts all DHCS SDOH ICD-10 Z Codes (All Plan Letter 21-009) and providers now qualify for a $100 payment per member, per provider federal tax ID, per ICD-10 diagnosis code, with a limit of $7,500 per tax ID within the CBI program year.

Retired measures

• No retired measures for 2026.