Magellan Healthcare
Provider Focus Newsletter
News & information for Magellan network providers

region/plan-specific news : California

California outpatient providers received $500,000 in bonuses in 2023

Maximize your bonus potential in 2024

Each quarter, Magellan* sends all high-volume outpatient behavioral health providers in California personalized practice dashboards, which display the provider’s results on several key clinical and quality measures of outpatient care.

In 2023, Magellan made a total of $500,000 in bonus payments to California providers who demonstrated high-quality outpatient services. Magellan anticipates making similar bonus payments in 2024.

Current California network providers: Maximize your bonus potential in 2024

Magellan calculates bonus payments as a percentage of each outpatient provider’s submitted Magellan claims.

Who's eligible?

All in-network, outpatient providers in California are eligible to receive a bonus, provided they met the quality and value criteria, and saw 30 or more Magellan members during the measurement period.

Quality metrics include:

Access and availability measures
  • Engagement and retention: New patient engagement and retention in outpatient treatment.
  • Accepting new patients: Number of new patients admitted to the practice.
  • Outpatient visits / patient: Average number of sessions per patient compared to network peers with similar practices/patient mix.
  • 7-day follow-up with new patients: New patients seen within seven days of discharge from an inpatient hospital.
  • 30-day follow-up with new patients: New patients seen within 30 days of discharge from an inpatient hospital.
Quality measures
  • Average inpatient admissions: Average number of inpatient admissions among your existing patients during the reporting period compared to network peers.
  • 7-day follow-up with existing patients: Existing patients seen within seven days of discharge from an inpatient hospital.
  • 30-day follow-up with existing patients: Existing patients seen within 30 days of discharge from an inpatient hospital.
  • Number of 30-day readmissions: Total number of inpatient readmissions for existing patients during the reporting period.
When will the bonuses pay out?
  • We estimate making the bonus payments for services rendered for the measurement period of July 2023 through June 2024 by the end of 2024.
  • We look to continue this program in 2025 with a similar bonus payment and structure. Maximize your 2024 bonus potential by 1) having high scores in the above-referenced quality metrics, and by 2) rendering services to 30 or more Magellan members.

 

*In California, Magellan does business as Human Affairs International of California, Inc. and/or Magellan Health Services of California, Inc. – Employer Services.

 

 

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About Provider Focus

Welcome to Provider Focus, our award-winning e-newsletter for network providers! Here you’ll find articles and information to keep you up-to-date on news and topics relevant to serving Magellan members, including a section for regional- and plan-specific news. Check back as a new issue is released each quarter.

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