REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
December 16, 2025
FROM
ANDREW GOLDFRACH, ARMC Chief Executive Officer, Arrowhead Regional Medical Center
SUBJECT
Title
Amendment to Hospital Per Diem Agreement with Inland Empire Health Plan
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 19 to Hospital Per Diem Agreement No. 20-887 with Inland Empire Health Plan, for reimbursement for medical services rendered to Inland Empire Health Plan members, to participate in the Global Quality Pay for Performance Program for program years beginning on 2026, with no change to the contract term of October 1, 2020 through December 31, 2026.
2. Direct the Clerk of the Board of Supervisors to maintain the confidentiality of Amendment No. 19, pursuant to Health and Safety Code Section 1457(c)(1).
(Presenter: Andrew Goldfrach, ARMC Chief Executive Officer, 580-6150)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Operate in a Fiscally-Responsible and Business-Like Manner.
Provide for the Safety, Health and Social Service Needs of County Residents.
FINANCIAL IMPACT
Approval of this item will not result in the use of Discretionary General Funding (Net County Cost). Expenditures incurred for the provision of services under Hospital Per Diem Agreement No. 20-887 (Agreement) are funded through reimbursements by Inland Empire Health Plan (IEHP). Adequate appropriation and revenue have been included in Arrowhead Regional Medical Center’s (ARMC) 2025-26 budget and will be included in the 2026-27 recommended budget.
BACKGROUND INFORMATION
On September 15, 2020 (Item No. 15), the Board of Supervisors (Board) approved the Agreement with IEHP to provide reimbursement for medical services rendered by ARMC to IEHP members for the period of October 1, 2020 through September 30, 2023. Eighteen amendments have since been entered into relating to the Agreement to allow ARMC to receive supplemental payments for Medi-Cal managed care capitation rate range increases, update program eligibility, amend compensation and reimbursement rates, enable participation in various incentive programs, and extend the term of the Agreement through December 31, 2026.
Approval of Amendment No. 19 to the Agreement will allow ARMC to participate in the IEHP Global Quality Pay for Performance (GQ P4P) Program starting on January 1, 2026. This program establishes measurable clinical and quality performance standards for Independent Physician Associations (IPAs) and is updated annually by IEHP in alignment with federal requirements for provider incentive arrangements (42 CFR §438.3(i)(3)(iii)). Participation in the GQ P4P Program enables ARMC to qualify for incentive payments based on performance on defined quality measures, with scoring methodologies, targets, and payment calculations published each year in IEHP’s program guide.
The program establishes transparent participation requirements, defined performance targets, and payment methodologies. Incentive payments are funded entirely through IEHP and contingent upon the availability of state-approved funding. As a contracted safety-net provider serving a large Medi-Cal population, ARMC’s inclusion in this program supports the goals to improve health outcomes, strengthen regional care coordination, and ensure financial sustainability through value-based payment arrangements.
Pursuant to Health and Safety Code Section 1457(c)(1), records that reflect specific terms related to the rates of payment for health care services are not immediately subject to laws related to public records; therefore, the Clerk of the Board is directed to maintain confidentiality of the amendments.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Charles Phan, Supervising Deputy County Counsel, 387-5455) on November 17, 2025; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on November 20, 2025; and County Finance and Administration (Jenny Yang, Administrative Analyst, 387-4884) on November 24, 2025.