Program Design & Implementation

Harbage Consulting has a long history of assisting state and local governments with public program design and implementation. Given our strong connection to the State of California, Harbage Consulting has played a key role over the past decade in several of the state’s health care initiatives, including the development and implementation of the nation’s first Medicaid Delivery System Reform Incentive Payment (DSRIP) waiver, the first Medicaid Section 1115 demonstration integrating care for individuals dually eligible for Medicare and Medicaid (Cal MediConnect) and the companion Coordinated Care Initiative, as well as implementation of the state’s most recent Medi-Cal 2020 waiver. Based on these experiences and our team’s collective expertise, Harbage Consulting has assisted many states and local governments with program design and implementation.

New York DSRIP


Harbage Consulting provided significant support to the New York Department of Health in designing the state’s DSRIP program, including providing technical support in program design, waiver financing, and project valuation. We subsequently worked with two New York City hospital systems in implementing DSRIP on the ground by providing technical assistance, strategic guidance and stakeholder engagement support. In addition, we assisted the two Performing Provider Systems in establishing their program governance structures and drafted the DSRIP implementation plans and quarterly data reports on their behalf. For more information on our work with New York’s Performing Provider Systems, see our Case Study.

Drug Medi-Cal Organized Delivery System


Harbage Consulting is supporting the California Department of Health Care Services in the planning and implementation of the Drug Medi-Cal Organized Delivery System (DMC-ODS) waiver program. This program aims to test a new paradigm for the organized delivery of health care services for Medicaid beneficiaries with a substance use disorder (SUD), while also demonstrating how organized SUD care improves outcomes for beneficiaries while decreasing health care costs. Harbage Consulting is:


  • Supporting the state by developing and executing a comprehensive stakeholder and county engagement and communications strategy that includes webinars and legislative briefings.
  • Developing frequently asked questions and fact sheets on key policy areas and responding to stakeholder questions related to the DMC-ODS. For more information about this work, see our DMC-ODS Case Study.

West Virginia SUD Waiver Development


We are providing policy and clinical expertise and strategic advice to the West Virginia Department of Health and Human Resources as it develops a Medicaid Section 1115 waiver proposal to provide a comprehensive set of services designed to treat and prevent Substance Use Disorders. Harbage Consulting is supporting state leaders as they think through the elements of the waiver design, determine the expanded set of benefits that will be provided under the waiver, and plan for recruiting and training SUD providers to ensure the state has a strong network of support and treatment options.

Medi-Cal 2020 Waiver Implementation


Harbage Consulting is providing ongoing support to the California Department of Health Care Services as the state implements its most recent Medi-Cal Section 1115 waiver, which was approved in December 2015. Our team:


  • Assisted the state in designing applications and selection criteria for the new Public Hospital Redesign and Incentives for Medi-Cal (PRIME) initiative as well as for the new Whole Person Care Pilots.
  • Leveraged our experience in New York implementing its DSRIP program to ensure that DHCS had the tools it needed to set up an effective PRIME application and review process.
  • Continues to assist the state in planning for the PRIME Learning Collaboratives that support the participating PRIME hospitals throughout the 5-year project implementation process. See our Medi-Cal 2020 Case Study for more information.

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