Quality Improvement and Health Equity
Contra Costa Health Plan is dedicated to ensuring the highest standards of care and service for our members. We continuously monitor and improve our healthcare practices through performance measurement, member feedback, and collaborative initiatives with healthcare providers.
Quality Improvement and Health Equity Program Structure
For detailed information on our Quality Improvement and Health Equity Program, including documents and evaluations by year, please see the links below:
Program Description, Evaluation, and Work Plans
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2025 QI Program
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Description | Work Plan | Evaluation (available 2026)
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Q1 Activities | Q2 Activities | Q3 Activities | Q4 Activities
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2024 QI Program
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2023 QI Program
NCQA Health Plan Accreditation
Contra Costa Health Plan has been accredited by the National Committee for Quality Assurance (NCQA) since 2014. NCQA Health Plan Accreditation is a nationally recognized evaluation that measures the quality of care and services provided by health plans. Our accreditation reflects CCHP's ongoing commitment to improving health outcomes and delivering high-quality, equitable care to our members.
Quality Measures and HEDIS
HEDIS® (Healthcare Effectiveness Data and Information Set) provides a comprehensive set of standardized performance measures that help us ensure the quality of care we deliver. Contra Costa Health Plan uses HEDIS measures to evaluate our performance in key areas such as preventive care, chronic disease management, and member satisfaction. Our commitment to quality is reflected by our performance in exceeding national performance benchmarks.
HEDIS® Performance Results
Quality Measurement Resources:
Value-Based Payments
CCHP is dedicated to aligning provider incentives with the quality of care delivered. Our Value-Based Payment Pay for Performance Program rewards providers for achieving high standards in patient care and outcomes. To review the program details and requirements, please see the program guides:
Health Education and Population Health
Contra Costa Health Plan is committed to promoting wellness and addressing health needs through our health education and population health programs. We offer providers access to our member-facing health education website and member newsletters which includes resources and tools designed to support our members' health. We also collaborate with providers to develop tailored health education materials, classes, and support resources. If you are interested in arranging health education classes or need educational support or materials for your office, please reach out to us at healtheducation@cchealth.org. Our health educators can do on-site classes, virtual classes, tabling at your site or at events, or one-on-ones with members.
Population Health Management
Understanding the diverse needs of our community is essential to providing effective healthcare services. Our Population Health Management strategy guides our efforts in identifying the health needs and characteristics of our members, with a focus on addressing health disparities. This strategy, along with our Population Needs Assessment, informs our quality improvement initiatives and helps us tailor programs to better serve our population.
- 2025 - Strategy | Population Needs Assessment (available 2026)
- 2024 – Strategy | Population Needs Assessment
- 2023 – Strategy | Population Needs Assessment
- 2022 – Strategy | Population Needs Assessment
Contra Costa County is in the process of developing its Community Health Assessment (CHA) and Community Health Improvement Plan (CHIP). CCHP sits on Contra Costa’s CHA/CHIP steering committee and contributes by providing data, member input through our Community Advisory Committee, and in-kind staff support. CCHP actively engages with the public health department to guide initiatives and inform programs that improve health outcomes across the county. Updates on Contra Costa's CHA/CHIP can be found here.
Contra Costa Health Atlas is a tool available for easy on-demand access to local data, allowing users to view information in maps, charts, or tables.
Non-Specialty Mental Health Services Outreach and Education Plan
CCHP is committed to ensuring that all members are aware of the non-specialty mental health service benefits and services available to them and how to access them. As part of our commitment, CCHP annually assesses those who are utilizing services and develops an outreach and education plan to inform members and providers of available benefits.
Cultural and Linguistic Services
CCHP is committed to delivering culturally and linguistically appropriate services to all members to ensure quality and equity care. Cultural and Linguistic Services Program is to plan, develop, implement, support, and evaluate the cultural and linguistic services available through CCHP. CCHP offers Interpreter Services at no cost to our members. Annually, CCHP assess the cultural and linguistic needs of members relative to its network capacity.
Access to Care
Ensuring timely access to care is a fundamental priority at Contra Costa Health Plan. We adhere to state access standards to guarantee that our members can easily reach the care they need. This includes monitoring and evaluating appointment scheduling, wait times, and the availability of urgent and routine care services. We are committed to maintaining these standards and continuously improving our access to care.
Initial Health Appointment
At Contra Costa Health Plan, we prioritize the health and well-being of our new members by ensuring they establish care promptly. To support effective care coordination, all new members are required to see their Primary Care Provider (PCP) within 120 days of enrollment. This initial visit is essential for establishing care, assessing health needs, and creating a personalized care plan.
Blood Lead Screening
Ensuring that all children receive timely blood lead tests is a key aspect of preventive care. According to California lead guidelines for Medicaid children, these tests are crucial for detecting and preventing lead exposure. We encourage providers to follow these guidelines and ensure screenings are completed. Guidelines and resources can be found below:
Member Experience and Provider Satisfaction Surveys
Contra Costa Health Plan values the feedback of both our members and providers. To continually improve our services and care, we conduct regular surveys to assess member experience and provider satisfaction. We use the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey, along with the Experience of Care and Health Outcomes (ECHO) survey, to evaluate member experience and identify opportunities for improvement. These surveys provide critical insights that guide our quality improvement initiatives, ensuring that we meet the needs and expectations of those we serve.
Member Experience Survey
Provider Satisfaction Survey
Facility Site Review
Contra Costa Health Plan conducts facility site reviews in accordance with standards set by the California Department of Health Care Services (DHCS). These reviews are designed to ensure that healthcare facilities within our network meet state requirements for quality and safety. By adhering to these standards, we help ensure that our members receive care in environments that are safe, well-maintained, and properly equipped.
Potential Quality Issues (PQI)
Potential Quality Issue (PQI) is a possible adverse variation from expected clinician performance, clinical care, or outcome of care. PQIs requires further investigation to determine whether an actual quality issue or opportunity for improvement exists. To report a potential quality issue, please fill out this form and email to qualityconcerns@cchealth.org.
Long Term Care Quality Assurance and Performance Improvement
CCHP is committed to ensuring members receive the highest quality of care in long term care settings. CCHP conducts quality assurance activities, including evaluating outcomes, identifying areas for improvement, and working with providers to improve care delivery.
Clinical Practice Guidelines
Contra Costa Health Plan is committed to supporting our providers with evidence-based clinical practice guidelines to ensure high-quality care and optimal patient outcomes. These guidelines cover a range of clinical areas and are regularly updated to reflect the latest research and best practices. Providers are encouraged to use these guidelines to inform their clinical decision-making and enhance patient care. All Clinical Practice Guidelines are reviewed and approved by CCHP’s Quality Council.
For access to our clinical practice guidelines and related resources, please visit:
Provider-Preventable Conditions (PPCs)
Provider Preventable Conditions (PPCs) include health care-acquired conditions (HCAC) in acute inpatient hospital settings and other provider-preventable conditions (OPPC) when they occur in any health care settings. Federal law mandates that providers report PPCs occurring during the treatment of Medi-Cal patients. This includes PPCs associated with Medi-Cal claims or courses of treatment, except those that existed before the provider began treatment.
Under the Federal Affordable Care Act section 2702 and Title 42 of the Code of Federal Regulations, sections 447, 434 and 438 also require that Medi-Cal and Medi-Cal Managed Care plans not reimburse for PPCs that occur during treatment. CCHP investigates all reported PPCs to determine if payment adjustment is necessary. Providers must report PPCs within five (5) business days of discovery by contacting QualityConcerns@cchealth.org. Please note that reporting PPCs for a Medi-Cal beneficiary does not preclude the reporting of adverse events and healthcare-associated infections (HAI) to the California Department of Public Health pursuant to Health and Safety Code.
Contact Us
For any questions or concerns related to quality improvement or population health, please contact us at cchp.quality@cchealth.org.
For questions or concerns related to patient safety, please contact QualityConcerns@cchealth.org