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Quality Performance

At IEHP, quality means focusing on the healthcare needs of our members and supporting our providers. We are committed to quality, driving us to create programs and services to meet the needs of our members and providers.

 

In fact, IEHP is one of the top-rated Medicaid plans in California. Determined by both the Healthcare Effectiveness Data and Information Set (HEDIS) and the Consumer Assessment of Healthcare Providers and Systems (CAHPS), NCQA has awarded IEHP an Accreditation status for Medi-Cal. This status is only given to health plans that have clinical and service programs that meet or exceed NCQA standards.

 

Learn more about how IEHP delivers quality services and care below. 

Quality Report

Inside the 2026 Quality Report, you will find we remain committed to "Elevate" health care in the Inland Empire. Through the lens of critical measures summarizing our performance over the past year, you can learn more about IEHP’s quality journey. We also show how the data translates into tangible outcomes for our members, providers and team members via the heartwarming features and stories of hope. While there were many areas where we excelled, there were also places where we found opportunities for improvement.

 

The goal of all IEHP quality reports is to be transparent – with you and with ourselves. This journey is ongoing, and we hope to always learn from it so we can do better and be better for those who rely on us the most.

Quality Management

IEHP supports an active, ongoing, and comprehensive quality management program with the primary goal of continuously monitoring and improving the quality of care, access to care, patient safety, and quality of services delivered to IEHP Members. The Quality Management (QM) Program provides a formal process to systematically monitor and objectively evaluate, track and trend the health plan’s quality, efficiency and effectiveness.

 

Quality Management Evaluation

 

Quality Management Program Description

 

Quality Improvement and Health Equity Plan

 

Quality Management and Health Equity Transformation Committee (QMHETC) Executive Summaries and Minutes

 

HEDIS

Every year, IEHP assesses the overall quality of health care experienced by IEHP members. To achieve this IEHP uses  NCQA, a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations and manages the evolution of HEDIS® which provides:

  • a set of standardized performance measures based on statistically valid samples of members
  • the public with information to compare health plan performance

HEDIS Rate:

Consumer Assessment of Healthcare Providers and Systems (CAHPS)

Each year, IEHP asks members to take the CAHPS® survey. This survey helps IEHP learn how well the health plan meets members’ needs and what can be improved by:

  • Asking members about their health care, like getting care, how doctors talk to them, customer service and care coordination.
  • Looking at what members need and expect for all types of plans.

 

CAHPS rates:

Physician Satisfaction

IEHP values a strong partnership with our providers. To support them we offer many services from online support, to a call center, to a dedicated service representative. That's why doctors think highly of IEHP. In fact, according to the 2025 Provider Satisfaction Survey conducted by SPH Analytics, 98.2% of physicians would recommend IEHP to other physicians.

Community Reinvestment Program

The California Department of Health Care Services (DHCS) has launched the Community Reinvestment Program. This program works to address health disparities (gaps in health) and invest in programs that improve the overall well-being of Medi-Cal members. It brings health plans, counties and community-based organizations together to create solutions that improve health for everyone.

 

IEHP does not need to submit a Community Reinvestment Plan to DHCS in 2026 because we do not meet the financial requirements for this program right now. Even so, we see the value of this program and the ways it could help us work even more closely with our community partners. We will keep watching for future changes and will look for chances to take part as the program grows.

 

IEHP will continue to invest in the Inland Empire through programs like Blue Zones, Vibrant Villages and community sponsorships. These efforts will continue and are not affected by this program.

 

We will monitor updates from DHCS and share new information here when it becomes available. If you have any questions, please email communityreinvestment@iehp.org.

 

Related Resources

DHCS Community Reinvestment Requirements (PDF)

Population Health – CHAs and CHIPs