What's New for the Care-Based Incentive Program
What's New for CBI 2023
New Programmatic Measures:
- Adverse Childhood Events (ACEs) Screening in Children and Adolescents: This measure was moved from exploratory to a programmatic measure. This measure is based on the percentage of members 1 – 20 years of age who are screened for ACEs annually.
- Health Equity: This measure was moved from exploratory to a programmatic measure category and will continue to assess race/ethnicity disparities in health plan performance using the child and adolescent well-care visits. The methodology has changed to close the gap to the 50th or 75th percentile by 50% based on the baseline rates for the various race/ethnicities from Q4 2022.
New Fee-For-Service (FFS) Measures:
- Adverse Childhood Experiences (ACEs) Training and Attestation: The plan shall pay providers, including mid-level providers and second- and third-year residents, for completing the ACEs Aware training and attestation. Providers will need to complete the ACEs Aware training thiab attestation to receive Prop 56 payment thiab to qualify for the new ACEs FFS measure.
Measure Changes – Redistribution of Points:
- Points were reallocated for the new Health Equity measure:
- Ambulatory Care Sensitive Conditions: 1 point removed
- Preventable Emergency Visits 1 point removed
- Initial Health Assessments 1 point removed
- Quality of Care Measures 2 points removed
See the 2023 CBI Incentive Summary for the full points breakdown.
New Exploratory Measures:
- Colorectal Cancer Screening: This measure looks at the percentage of members 45–75 years of age who had appropriate screening for colorectal cancer. For members 46-75 years you can use any of the following criteria for compliance:
- Fecal occult blood test within the last year.
- Flexible sigmoidoscopy within the last 5 years.
- Colonoscopy within the last 10 years.
- CT colonography within the last 5 years.
- Stool DNA (sDNA) with FIT test within the last 3 years.
- Unhealthy Alcohol Use in Adolescents and Adults
- Asthma Medication Ratio
- 90-Day Referral Completion
- Tuberculosis (TB) Risk Assessment