​​​​​​​​​​Public Hospital Redesign & Incentives in Medi-Cal Program

Back to the Medi-Cal 2020 Waiver homepage.

The Public Hospital Redesign and Incentives in Medi-Cal (PRIME) program will build upon the foundational delivery system transformation work, expansion of coverage, and increased access to coordinated primary care achieved through the prior California Section 1115 Bridge to Reform demonstration. Activities supported by the PRIME program are designed to accelerate efforts by particip​ating PRIME entities to change care delivery to maximize health care value and strengthen their ability to successfully perform under risk-based alternative payment model​s (APMs) in the long term, consistent with CMS ​and Medi-Cal 2020 goals. The PRIME program is intentionally designed to be ambitious in scope and time-limited. Using evidence-based, quality improvement methods, the initial work will require the establishment of performance baselines followed by target setting and the implementation and ongoing evaluation of quality improvement interventions. Participating PRIME entities will consist of two types of entities: Designated Public Hospital (DPH) systems and the District/Municipal Public Hospitals (DMPH). For more details, please see the PRIME fact sheet.

Stakeholder Engagement

As required by the Medi-Cal 2020 Waiver Special Terms & Conditions, DHCS conducted two stakeholder engagement sessions to inform the public of DHCS’s PRIME 5-Year Project Plan review and approval process and engage the public for comment.

• PRIME Webinar (April 11, 2016):  Recording  |  Presentation  |  Medi-Cal 2020 Crosswalk
• PRIME In-Person Meeting (April 19, 2016):  Agenda  |  Presentation  |  Medi-Cal 2020 Crosswalk

Resources & Information

• Medi-Cal 2020 Waiver Special Terms & Conditions (for PRIME, see STCs 74-107 on pages 50-73)
• CMS Approval of PRIME Protocols
• Attachment D - Participating PRIME Entities
• Attachment Q - PRIME Projects and Metrics Protocol​
  
• COVID-19 Flexibilities ​for PRIME CMS Approval Letter​
  
• Attachment II - PRIME Program Funding and Mechanics Protocol (Amended due to COVID-19)
  

• PRIME 5-Year Project Plans
• 5-Year Plan Application Template​
  
• 5-Year Plan Prime Project Selections
• Approved 5-Year Project Plans
  

• PRIME Evaluation Desi​​gn
  
• Cover Letter to ​CMS
  
• Final Evaluation Design | CMS Approval Letter
  
• PRIME Interim Evaluation Website​ and Report
• PRIME Preliminary Summative Evaluation
  
• PRIME Summative Evaluation Infographic​
  
• PRIME Final Summative Evaluation​
  
• PRIME Payments
  
• Paid Amounts
  
• PRIME DY 12 
• PRIME DY 13
  
• PRIME DY 14​
  
• Summary of PRIME Entities Utilizing Tele-health​​

Questions & Comments

Please direct comments, questions or suggestions regarding the PRIME program to the following email: PRIME@dhcs.ca.gov.