This is part of an ITUP series on the Medi-Cal 2020 §1115 waiver renewal.
Before the Medi-Cal 2020 waiver, the federal/local financing of care for the uninsured was anachronistic. It incentivizes treating uninsured individuals at the hospital emergency room (the most expensive setting) at the latest possible stage of illness (the most expensive point in an illnesses trajectory). Public Hospital Redesign and Incentives in Medi-Cal (PRIME), a program in the newest waiver, will be assisting public hospitals in transforming their delivery systems to one that is compatible with Medi-Cal managed care; it will replace fee-for-service (FFS) payments with ones involving value, improved patient outcomes, capitation, and other alternative payment methods. Similar to PRIME, the Global Payment Program (GPP) aligns incentives to treat the uninsured population outside the hospital, by improving access to preventive and primary care.
Download the full analysis: §1115 Waiver Renewal Analysis: Global Payment Program (GPP)