- What is the purpose of the “My Health LA Incentive Project”?
The purpose of the project is to incentivize CPs to bring MHLA participants into their assigned medical home clinic for in-person “Included Services.”
- Where is the “My Health LA Incentive Project” Provider Information Notice posted?
The PIN is posted on the MHLA website here: http://file.lacounty.gov/SDSInter/dhs/1113588_PIN21-01.pdf
- Do we need to sign up for this or does it just become part of our regular work with added reimbursement if we show the desired improvements?
No, all CPs are automatically participating. MHLA will calculate the visit rate after the end of the fiscal year and will measure improvement.
- How is the 9-month visit rate calculated?
The 9-month visit rate is calculated by taking all the individuals enrolled in June 2021 and then determining how many of those individuals came in person in the prior 9 months for an included visit (see the PIN that lists all the CPT codes that count as included visits). We will calculate the final visit rate the same way but based on the June 2022 enrollment.
CPs should try to keep participants enrolled too or help them renew if they have been disenrolled. Resource materials for how to conduct renewal campaigns are posted on the MHLA website under Enrollment & One-e-App.
- Does the CP need to conduct its own outreach to bring in MHLA patients back into the clinic?
We encourage CPs to do outreach to bring MHLA participants back to in-person care. Some possible ways to do such outreach are through text campaigns, phone calls or letters.
- Can DHS support the CPs with an outreach strategy?
Each CP is responsible for developing and implementing its own outreach strategy.
- What steps would we need to take (or what data submitted) to receive the incentive?
CPs do not need to submit any additional data.
- What CPT codes are counted as included visits?
The CPT codes counted as included visits are listed here: 1047286_PIN1806–AcceptableCPTCodesNov12018.pdf (lacounty.gov)
- Will CPs receive different amounts of incentive money?
Yes. The incentive money is based on a percentage of the MGF that was paid last fiscal year. CPs with higher enrollment have the possibility of receiving a higher incentive payment. Those CPs, however, also must bring in more of their enrolled participants for in-person visits.
- Will this quality incentive project be repeated?
No. This is a one-time quality incentive project for FY 21-22.
- Will telehealth visits count for the purposes of this incentive project?
No. The goal of the incentive project is to bring MHLA participants back for in-person care. As a reminder, telehealth visits also do not count for purposes of MGF payment. Any claims for telehealth visits should be submitted with the telehealth modifier.
