Pay-for-Performance (P4P) and Quality Program Support
Pay-for-performance revenue depends on closing quality-measure gaps and getting complete, accurate data to the health plans that score them. Quantix Health helps Southern California practices align with HEDIS and California's IHA Align. Measure. Perform. program, close care gaps, and reconcile the incentives they have earned.
- HEDIS and IHA measure gap closure support
- Supplemental data capture and submission
- Incentive reconciliation against plan reports
Specialty expertise, not generic billing
Measure gap closure
We help identify open HEDIS and P4P measure gaps across the panel and route them to the right care and coding actions before measurement periods close.
Supplemental data
We help capture and submit supplemental clinical data so services already delivered are credited by the plan rather than counted as gaps.
IHA AMP alignment
We map practice reporting to California's IHA Align. Measure. Perform. measure set and each plan's program so effort targets the measures that pay.
Incentive reconciliation
We reconcile plan incentive statements against delivered and documented care so earned dollars are not left unclaimed or under-paid.
Where pay-for-performance and quality programs lose revenue
These are the specialty-specific leaks we watch for — and fix at the root.
- Care that closes a measure is often delivered but never credited because supplemental data is not submitted to the plan.
- Each health plan uses overlapping but different measure sets and thresholds, making a single quality workflow hard to run.
- Measure gaps surface too late in the year to act on before the measurement period closes.
- Coding and documentation gaps cause completed services to miss HEDIS numerator requirements.
- Incentive statements are difficult to reconcile against actual performance, so under-payments go unnoticed.
- Aligning to California's IHA AMP measure set alongside individual plan programs adds reporting complexity.
Full support for pay-for-performance and quality programs
One accountable partner for billing and the business side of your practice.
Revenue Cycle Management
End-to-end RCM — eligibility, coding, claims, denials, A/R, posting, and reporting, all under one roof.
Learn moreCredentialing & Enrollment
Payer enrollment and credentialing so your providers can bill without delay.
Learn moreMedical Support Staffing
Vetted, remote billers, coders, and back-office staff — dedicated to your practice, when and where you need them.
Learn morePractice Management Consulting
Operational, financial, and compliance consulting to run a healthier, more profitable practice.
Learn moreCommon questions
What quality programs do you support in California?
We support HEDIS-based measures and California's IHA Align. Measure. Perform. program, along with individual commercial and Medi-Cal managed care plan incentive programs. We help align reporting to the specific measure sets each plan scores.
How does supplemental data improve our scores?
Many services that close a measure are delivered but not visible in claims data, so the plan counts them as open gaps. Submitting supplemental clinical data credits that care to the numerator, improving measured performance without additional visits.
Can you help us confirm we were paid correctly on incentives?
Yes. We reconcile plan incentive statements against your documented performance to surface under-payments and missed credits. Because measure specifications change each year, we recommend verifying current IHA and plan program guidance.
Billing guides for pay-for-performance and quality programs
Let's strengthen your pay-for-performance (p4p) revenue
Book a free, no-obligation consultation. We'll review your billing and show you the opportunity — no pressure.