Quality ManagementMedicaidJune 5, 2025

Quality Incentive Program offerings for measurement year 2025

If you are a Medi‑Cal Managed Care …

Program

Domains

Payouts

Dollars per benchmark

IPA/PMG

Medi‑Cal Value Payment (MVP)

1 (HEDIS® measures)

1 (based on final 2025 performance)

75th percentile; 100% of dollars per measure

50th percentile; 75% of dollars per measure

25th percentile and YOY improvement; up to 50% of dollars per measure

Clinic with 1,000 or more members

Clinic Pay for Performance (CP4P)

2 (HEDIS measures and improvement activities)

2 (projected and final 2025 performance)

75th percentile; 100% of dollars per measure

50th percentile; 75% of dollars per measure

25th percentile and YOY improvement; up to 50% of dollars per measure

Clinic with fewer than 1,000 members

Direct to Provider (DTP)

1 (HEDIS measures)

1 (based on final 2025 performance)

75th percentile; 100% of dollars per measure

50th percentile; 75% of dollars per measure

25th percentile and YOY improvement; up to 50% of dollars per measure

HEDIS measures in scope for 2025

Asthma Medication Ratio (AMR)
Breast Cancer Screening (BCS)
Controlling High Blood Pressure (CBP)
Cervical Cancer Screening (CCS)
Childhood Immunization Status Combination 10 (CIS‑10)
Chlamydia Screening in Women (CHL)
Glycemic Status Assessment for Patients with Diabetes (GSA)
Immunizations for Adolescents Combination 2 (IMA‑2)
Lead Screening in Children (LSC)
Prenatal and Postpartum Care Pre (PPC‑Pre)
Prenatal and Postpartum Care Post (PPC‑Post)
Well‑Child Visits in the First 30 Months of Life (2+) (W30‑2+)
Well‑Child Visits in the First 30 Months of Life (6+) (W30‑6+)
Child and Adolescent Well‑Care Visits (WCV)

For more detailed information and to see if your clinic qualifies, email CAMedicaid@anthem.com with your name, NPI, and clinic address. A current IRS Form W-9 will be required to participate.

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Blue Cross of California Partnership Plan, Inc. are independent licensees of the Blue Cross Association. Blue Cross of California is contracted with L.A. Care Health Plan to provide Medi-Cal Managed Care services in Los Angeles County. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

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