Public health care systems reach a record high in Quality Incentive Pool scores, reflecting improved care for Medi-Cal patients
California’s public health care systems achieved their best performance to date in the Quality Incentive Pool (QIP) in 2024, with 16 of 17 systems earning a 100% aggregate score.*
That is up from 11 systems in 2023, a significant increase of roughly 45% in the number of systems reaching the top QIP score.
QIP is a sweeping, State directed payment program. A value-based care model, QIP ties essential funding to how well public health care systems perform on 40 quality measures. This pay-for-performance funding enables systems to implement thecomprehensive transformations necessary to deliver higher-quality care to Medi-Cal patients.
“Participation in QIP is painstaking work in which our member public hospitals and health systems strive to meet ambitious goals amid competing priorities, limited resources, and a volatile health care environment,” said Ash Amarnath, MD, chief health officer, California Health Care Safety Net Institute (SNI).
“Despite these pressures in 2024, health systems’ steadfast commitment to their patients meant they kept rising to meet these QIP goals. Remarkably, they overdelivered. They reported their best year of quality performance and better care for the patients they serve. We are deeply proud of their achievements, especially today.”
Where care is improving
As a result of systems’ focused efforts to improve performance on QIP measures last year, more patients received timely preventive care, better chronic disease management, and other core services that helped them stay healthy and avoid hospitalization.
In 2024, public health care systems posted their strongest results on the three QIP measures below. For each measure, we highlight a few examples of strategies used to improve performance.
Highest-performing QIP measures:
Developmental screening in the first three years of life. Systems used community health worker–led outreach to address barriers to care, focused on closing disparity gaps by race and ethnicity, and expanded use of Ages & Stages Questionnaires to identify developmental needs earlier.
Breast cancer screening. Systems expanded access with Saturday and/or extended-hours appointments, strengthened collaboration with radiology departments to streamline scheduling and follow-up, and engaged in targeted outreach to patients.
Controlling high blood pressure. Systems partnered with Medi-Cal managed care plans to provide home blood pressure cuffs so patients could monitor their readings, used second blood pressure readings in visits to confirm elevated results, and conducted targeted outreach and follow-up with patients needing support.
Standout improvement at Arrowhead Regional Medical Center
Among the six public health care systems with the largest year-over-year improvement in QIP performance from 2023 to 2024, Arrowhead Regional Medical Center (ARMC) posted the highest gain, with a 45% increase in its aggregate QIP score.
This accomplishment largely reflects the system’s investment in data infrastructure and data alignment, including strengthening data exchange and building a closer partnership with its local Medi-Cal plan. This work ultimately led to more coordinated and tailored programs and services that more effectively meet patients’ needs.
“Achieving this level of improvement in QIP performance took sustained, behind-the-scenes effort across our clinical, operational, and analytics teams,” said Andrew Goldfrach, chief executive officer, ARMC. “I am proud of how our teams persisted, because every step forward in these quality measures resulted in better care for the patients and communities we serve.”
How SNI supports system success
SNI plays an important role in helping our member public health care systems navigate QIP so they can succeed—and, ultimately, so Medi-Cal patients benefit. We do this by:
Convening learning collaboratives. SNI brings systems together through learning collaboratives, workshops, and webinars where teams share strategies, address common implementation challenges, and hear from member speakers about best practices for achieving high performance. Many of these convenings are shaped by a common question from members: “What are other systems doing to address this challenge?”
Providing one-on-one expert guidance. Our QIP experts work directly with system teams to interpret the program’s complex requirements, as well as navigate performance measurement and reporting challenges.
Offering data analytics support. We track performance across systems to identify gaps and create opportunities to overcome obstacles by spreading successful practices.
Maintaining regular touchpoints with QIP teams. We meet biweekly with systems’ QIP teams to share program updates, review policy clarifications, and answer questions.
SNI, along with our partner organization CAPH, also helps to lift up quality by recognizing exemplary efforts through our annual Quality Leaders Awards (QLA).
At the 2025 CAPH/SNI Annual Conference, six public health care systems were honored for innovative, equity-focused efforts to improve care for their communities. Read the full announcement and watch short videos about each initiative.
*In QIP, a 100% aggregate score means a system earned at least 40 total points across all measures. No system met the target on all 40 measures. Instead, some exceeded the target on certain measures and received “overperformance” points. These are extra points awarded for very high performance, and they offset lower performance on other measures.
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