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California Public Hospitals Improved Quality of Care Under Medicaid Waiver Program

Publication Topics

Health Care Delivery System; Health Care Economics; Health Promotion/Disease Prevention Issues; Low-Income; Medicaid/Medi-Cal

Publication Type

Policy Brief

Publication Date


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<a onclick="OpenPopUpPage('{7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=94&RootFolder=*', RefreshPage); return false;" href="{7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=94&RootFolder=*">Nadereh Pourat, PhD</a>

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California has 12 county-owned and operated hospital systems and 5 University of California hospitals designated as public hospitals. These organizations deliver the majority of inpatient care and a significant amount of outpatient care to Medicaid patients in the state. In 2010, California was the first state in the nation to implement a five-year Delivery System Reform Incentive Payment (DSRIP) program under the Section §1115 Medicaid “Bridge to Reform” waiver to improve the capacity of these hospitals to deliver high quality and more efficient care. The California DSRIP was the first program in a continuing national initiative to reform the Medicaid delivery system while remaining budget neutral.

This policy brief summarizes results from an extensive evaluation that revealed major advances in infrastructure development, delivery of health care, and patient outcomes during the program. The results highlight the importance of joint federal and state investments in bolstering the capacity of safety net providers to deliver high-quality care, and they emphasize the need for continued investment in the safety net. The California DSRIP was followed by a program called Public Hospital Redesign and Incentives in Medi-Cal (PRIME), which incentivizes improvements in expanded and new areas of care not addressed by DSRIP.


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Policy Brief: California Public Hospitals Improved Quality of Care Under Medicaid Waiver Program

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Related Report: Final Evaluation Report of California's Delivery System Reform Incentive Payments (DSRIP) Program

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Press Release

Related Link 1

California Department of Health Care Services

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Blue Shield of California Foundation

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Created at 6/1/2017 4:14 PM by i:0#.f|uclachissqlmembershipprovider|gwendolyn
Last modified at 1/21/2020 11:30 AM by i:0#.f|uclachissqlmembershipprovider|bhan