California Value Based Pay for Performance (VBP4P)

The California Value Based Pay for Performance (VBP4P) program is the largest alternative payment model in the United States. Founded in 2001, it is a statewide initiative managed by the Integrated Healthcare Association (IHA) on behalf of 9 health plans representing a significant number of HMO/POS members in California. IHA is responsible for collecting data, deploying a common measure set and reporting results for approximately 200 physician organizations (PO). The program represents the longest running U.S. example of data aggregation and standardized results reporting across diverse regions and multiple health plans. California consumers benefit from the availability of standardized performance results from a common measure set, available to the public through the State of California, Office of the Patient Advocate (OPA) Health Care Quality Report Card. 

The National Committee for Quality Assurance develops and maintains the clinical measures and audit methodologies and evaluates and collects data for the Advancing Care Information (ACI) domain. The majority of clinical quality measures are adapted from the NCQA Healthcare Effectiveness Data and Information Set (HEDIS)® measures, the most widely used set of performance measures in the managed care industry. Non-HEDIS measures are noted in the specifications. 

Value Based Pay for Performance (VBP4P) Manual and Value Set Directories (VSDs)

The Value Based P4P manual and Value Set Directories (VSDs) are a required resource for California stakeholders participating in the Integrated Healthcare Association’s (IHA) California Value Based Pay for Performance (VBP4P) program. The Value Based P4P Manual features the technical specifications for all VBP4P measures as well as VBP4Ps general guidelines for data collection and reporting.

The Value Based P4P VSDs provide an easy way to incorporate CPT©, ICD-9-CM, POS, MS-DRG, HCPCS, LOINC, TOB, CVX, RXHCC and UB codes into your organization’s data collection program—saving programming hours, eliminating the manual search for codes and reducing keying errors. The Value Based P4P VSD consist of an electronic locked Excel file that is searchable and sortable.

The Value Based P4P Value Set Directory download includes the following files: 

  • The Value Based P4P Manual
  • The Value Based P4P Value Set Directory 
  • The Value Based P4P Value Set User Manual
  • The PQA NDC Code List
  • The PQA ICD Code List

The most current Value Based P4P Manual and VSDs can be downloaded at no charge from the NCQA Store.  A copy of the Value Based P4P Manual is also available on the IHA website.

Value Based P4P Resources