All new Alliance members must receive an Individual Health Assessment (IHA). The IHA consists of a history, review of systems, physical exam, preventive services and the Individual Health Education Behavioral Assessment (IHEBA). For Medi-Cal members, this must be completed within 120 days of enrollment. Alliance network PCP compliance will be assessed during site audits. The IHA completion rate is also a part of the annual Pay-for-Performance (P4P) program incentive.
The IHA should consist of an evaluation sufficient to enable Alliance network PCPs to assess the acute, chronic, and preventive health needs of the member and assume responsibility for effective management of the member’s health care service needs.
The required IHEBA forms can be found on the California Department of Health Care Services (DHCS) website.
For children, the IHA must consist of the elements found in the most recent periodicity schedule recommended by the American Academy of Pediatrics (AAP). PCPs must provide preventive health visits for all members under 21 years of age at times specified by the most recent AAP periodicity schedule. The schedule requires more frequent visits than the periodicity schedule of the Child Health and Disability Prevention (CHDP) program. The IHA must bring members up to date with all currently recommended preventive services and include all assessment components required by the CHDP for the younger age nearest to the child’s current age.