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§1115 Waiver Renewal Analysis: Public Hospital Redesign and Incentives in Medi-Cal

This is part of an ITUP series on the Medi-Cal 2020 §1115 waiver renewal.

Public Hospital Redesign and Incentives in Medi-Cal (PRIME) is an ambitious follow-up program to the successful Delivery System Reform Incentive Pool (DSRIP) for county, district, and University of California hospitals. Up to $7.5 billion will be used to transition public hospital systems to managed care models. This includes shifting the prevailing current fee for service (FFS) payment model in public hospitals towards alternative payment method (APM) models that incorporate more risk-based methodologies. Public hospital systems will be held even more accountable for cost and quality outcomes for their managed care systems. PRIME will accelerate this transition and root APM as the enduring and new standard for payment to public hospitals. Incentives will help hospitals better integrate different aspects of care, increase team-based care, improve population health and practice resource stewardship.

Download the full analysis: §1115 Waiver Renewal Analysis: Public Hospital Redesign and Incentives in Medi-Cal

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