Elevating Clinical Quality

L.A. Care’s Population Health Management (PHM) Program strives to address health needs at all points along the continuum of health and well-being, through participation engagement and targeted interventions for the member population across all lines of business.

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L.A. Care Health Plan's Provider Incentive Programs offer performance-based incentives to qualified high-volume physicians and higher-volume Community Clinics that provide high-quality preventive and chronic care to L.A. Care members.

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We have HEDIS^® (Healthcare Effectiveness Data and Information Set) reference guides for selected priority measures. These guides are designed to help your practice provide the best quality care, in alignment with the HEDIS^® standards as well as with evidence-based clinical practice guidelines.

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The Quality Improvement (QI) program serves to support the practitioner-patient relationship. QI measures progress and quality of care through HEDIS^®and the Consumer Assessment of Healthcare Providers and Systems (CAHPS^®) survey. We also offer providers opportunities to collaborate with L.A. Care and improve services to members.

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L.A. Care offers free resources to help you educate patients on health topics. These include materials (to order and to print) and classes at our Family Resource Centers that you can refer patients to attend. 

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View the Clinical Practice and Preventive Health Guidelines adopted by L.A. Care. You can also download preventive health guideline brochures to display in patient areas.

Go to Practice Guidelines

The Department of Health Care Services (DHCS) will transition the Child Health and Disability Prevention (CHDP) program to Managed Care Health Plans as of July 1, 2024. Learn what L.A. Care is doing and what you need to be aware of during this transition.

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The California Department of Health Care Services (DHCS) Policy Letter 14-004 requires a review of all primary care provider (PCP) sites upon entering our provider network and at minimum every three years thereafter. The review includes a site review survey, medical record review survey, and physical accessibility review survey assessment.

Go to Facility Site Review Resources

L.A. Care Health Plan monitors practitioner network availability and accessibility and telephone access to member services annually. L.A. Care, The California Department of Managed Health Care (DMHC) and the California Department of Health Care Services (DHCS) have established quantifiable standards for both the number and geographic distribution of practitioners and driving distances to pharmacies and access standards for services.

L.A. Care uses guidelines to ensure that its members have access to care:

Access to Care Standards