Case Studies

Since January 2015, Harbage Consulting has been working closely with the California Department of Health Care Services to provide policy analysis, technical assistance, strategic guidance and stakeholder engagement support as the state developed and negotiated a renewal of its Medicaid section 1115 waiver. The state’s waiver renewal – known as Medi-Cal 2020 – was approved on December 30, 2015. Once the waiver was approved, Harbage Consulting continued to support the state in planning for and implementing two of the main components of the waiver – the Public Hospital Redesign and Incentives for Medi-Cal (PRIME) program and the Whole Person Care pilots.

Building on experience working on delivery system reform in both California and New York as well as experience working in the federal government at the Centers for Medicare & Medicaid Services, Harbage Consulting is supporting the state by:


  • Providing strategic and policy advice on federal priorities related to the development, review and negotiation of Medicaid section 1115 waivers;
  • Drafting policy memos and presentations on delivery system reform and waiver implementation;
  • Designing the applications for hospital participation in the PRIME program and the application for the Whole Person Care pilots;
  • Developing review criteria for the applications and assisting the state in the review process; and
  • Planning for stakeholder engagement activities and assisting the state in designing the PRIME Learning Collaboratives.


In addition, Harbage Consulting developed a comprehensive summary of the approved Medi-Cal 2020 waiver for public release as well as a fact sheet providing an overview of the third key element of the waiver renewal – the Global Payment Program.


The State of California is one of the leading states in the nation in implementing delivery system transformation efforts. The state has utilized the infusion of federal support for DSRIP over the past six years to advance strategies for achieving the goals of the Triple Aim and to change the way care is delivered and paid for.

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At the intersection of health care policy, politics and communications.