PRIME/Waiver Update

Dear CEOs and CFOs of district/municipal hospitals:

We wanted to take this opportunity to let you all know of the terrific work being done by the PRIME teams at your hospitals. In October, I provided an update to DHCS and many other Medi-Cal stakeholders based on your DY 12 year end reports. All districts have done great work in putting in place the infrastructure to begin the pay-for-performance component of the program currently underway. The group of stakeholders (DHCS, patient advocates, provider organizations, foundations, etc.) was pleased and interested to hear of the examples of projects in your communities, such as expanding or implementing various health care services (e.g. behavioral health programs). Additionally, I was able to share some of the successes you’ve seen already in PRIME (patients with improved health status, better coordination of care in your communities including working with other community providers, and lowering costs by addressing quality of care or providing services in a more appropriate setting and/or reducing readmissions). All districts/municipal hospitals appear to be well poised for the next phase.

On November 14 and 15, the PRIME teams from all PRIME entities (county, UC, district and municipal hospitals) met in Sacramento for a one-day learning collaborative. In addition to the program, it provided PRIME staff an opportunity to network, share challenges and successes. DHCS Director Jennifer Kent kicked off the meeting and stated that DHCS would be pursuing a waiver in 2020. (More to come on the DHLF plans related to the PRIME successor program.)

As part of the learning collaborative, a poster session was a requirement. Each facility produced a poster that focused on the goals of PRIME and how PRIME is achieving transformation in your facility. I am NOT exaggerating when I tell you the posters were excellent! (And I may be biased but putting that aside and state completely objectively, the district/municipal hospitals all surpassed the county/UC facilities in their creativity of the presentation of PRIME projects in poster form.) We will have representations of the posters at the January Board meeting, but I’m attaching iPhone photos (so not the best quality) of the three winners (voted on by all meeting attendees) in the DMPH category:

3rd – John C. Fremont Hospital
2nd – Bear Valley Hospital
1st – Mendocino Coast District Hospital

This program is not without its challenges, but you all should be proud of the work that is being done under PRIME.

If you have questions or suggestions, as always, please contact Forum staff.

Sherreta Lane