Proposition 56 - Value Based Payment

*UPDATE: Although the VBP program ended as of DOS June 30, 2022, payments will run out through June 2023.

The Proposition 56 VBP Program provided direct payments incentivizing Providers to meet specific measures aimed at delivering key quality healthcare services that improve the quality of care to Medi-Cal beneficiaries. Targeted areas were behavioral health integration, chronic disease management, prenatal/post-partum care and early childhood prevention. For more information about the VBP Program, please visit the DHCS website at https://www.dhcs.ca.gov/provgovpart/Pages/VBP_Measures_19.aspx. By clicking on this link, you will be leaving the IEHP website. 

Value Based Payments Program Guide

• Value Based Payments (VBP) Program Guide (PDF) - Published: October 16, 2023

Value Based Payments Dispute Forms

• Value Based Payments Program - Paid Claims Dispute Request (PDF) Published: January 19, 2022
• Value Based Payments Program - Encounter Dispute Request (PDF) Published: January 19, 2022

Please e-mail completed forms to ValueBasedPaymentsProgram@iehp.org

At-Risk Condition Codes

The At-Risk Condition Codes list includes diagnosis codes to identify Serious Mental Illness, Substance Use Disorder or Homelessness Conditions for the VBP Program. These conditions qualify Providers for an additional payment amount for VBP services. Please refer to page 4 of the VBP Program Guide for additional details.

• At-Risk Condition Codes (PDF) Published: March 25, 2020
   

You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.