New Advanced Technology to Detect Bladder Cancer

Tenet Health Central Coast Sierra Vista Regional Medical Center now offers Blue Light Cystoscopy with Cysview®, an advanced technology for detecting bladder tumors that are too small to find with standard cystoscopy. If you know or suspect that a patient has bladder cancer, Cysview is a minimally invasive procedure that can detect bladder cancer cells. Benefits include:

■ Better inspection of the bladder for cancer, especially small or flat tumors

■ Better removal of bladder tumors when they are first discovered

■ Fewer recurrences of bladder cancer

■ Improved information for planning future care for bladder cancer

Sierra Vista Regional Medical Center is the only healthcare organization in San Luis Obispo County to offer Blue Light Cystoscopy with Cysview.

$7.3M Payout Rewards Physician Excellence

in Healthcare on Central Coast

CenCal Health’s provider incentive program supports quality of care for Medi-Cal members

In March of last year, CenCal Health launched the Quality Care Incentive Program (QCIP) to maximize the quality of care for its health plan members on the Central Coast. QCIP is a value-based incentive program that directly rewards plan providers who deliver exceptional medical care in their community. After nine months, the innovative initiative resulted in a distribution of over $7 million in payments to participating primary care providers (PCPs). endorsed standard for quality measurement in managed care, the NCQA HEDIS® Volume 2 Technical Specifications.

QCIP emphasizes the clinical priorities of significance to CenCal Health members, such as diabetes and asthma care, breast cancer and cervical cancer screenings, and child and adolescent well-care visits. In Santa Barbara and San Luis Obispo counties, CenCal Health is the Medi-Cal plan that partners with over 1,500 local physicians, hospitals, and other providers in delivering patient care to more than 225,000 members.

Replacing five different incentive programs previously utilized, the single integrated QCIP more extensively supports PCPs to achieve excellence in quality care. Performance is measured monthly and follows pre-defined, industry-standard measurement specifications maintained by the National Committee for Quality Assurance (NCQA).

To promote health equity, QCIP payments are also tied to the diversity of member patients managed by each PCP; as such, payments increase to reflect the proportion of members of greater clinical complexity, for example, the aged or those disabled.

In July 2022, CenCal Health distributed over $3.5 million in QCIP payments to 85 eligible PCPs, marking the first payment for the recently launched pay-for-performance program. In October, the second payout –totaling $3,751,527 – was distributed to 86 PCPs in Santa Barbara and San Luis Obispo counties.

To monitor progress, PCPs receive monthly performance reports and actionable gaps in care data through CenCal Health’s secure provider portal. No measures used in CenCal Health’s payment calculations encourage withholding of services. Payments are distributed quarterly.

With a vision to be a trusted leader in advancing health equity so that the communities we serve thrive and achieve optimal health, CenCal Health invites the public to review its 2023-2025 Strategic Plan at www.cencalhealth.org/strategicplan.

To implement QCIP, CenCal Health’s quality management team, under the direction of Quality Officer Carlos Hernandez, collaborated with all internal departments at the local health plan, and external organizations such as the California Department of Health Care Services, as well as several representative primary care providers.

“This incentive program relies on longstanding commitment and participation from our primary care provider partners, which, I’m proud to report, is in abundance,” said Hernandez.

“QCIP is an innovative value-based incentive program,” said CenCal Health CEO Marina Owen. “As a community-based health plan, we are committed to supporting local providers through programs such as this one.”

In 2003, the Centers for Medicare & Medicaid Services established pay-for-performance initiatives to control healthcare costs and to increase access to care by encouraging more physicians to participate in Medicaid health plans. More recently, incentive programs have evolved to emphasize quality of care, especially the prevention and management of chronic conditions.

QCIP was designed to encourage increased utilization of evidence-based treatment, screening, and preventive health services. The program encompasses five clinical categories of care – Women’s Health, Pediatric Care, Behavioral Health, Respiratory Care, and Diabetes Care – using the most widely

“An exemplary example is Dr. Jeffrey Kaplan, who has demonstrated a track record of extraordinary QCIP performance. Dr. Kaplan’s performance was especially exceptional for pediatric preventive care well-child visits.”

Jeffrey S. Kaplan, MD (pictured) is a pediatrician in Santa Maria, in practice for over two decades. “QCIP is unique, in that the incentives offered only promote increased use of services, aligned with widely accepted, evidence-based treatment recommendations,” said Kaplan.

More information on the Quality Care Incentive Program and CenCal Health is available at cencalhealth.org

Central Coast Vein & Vascular is the most advanced treatment center for varicose veins and arterial disease in the region. Our board-certified vascular specialist performs minimally-invasive, out-patient treatments that require little to no down time and result in successful outcomes.

• Varicose veins

• Heavy, aching, or swollen legs

• Non-healing leg wounds

• Blood clots

• Peripheral arterial