Program Implementation

Based on our firm’s extensive experience in Medicaid policy consulting and our team’s collective policy expertise, Harbage Consulting routinely assists states and local governments in implementing their health care programs and initiatives.

Click on the projects below to learn more about our work.

Drug Medi-Cal Organized Delivery System

Since 2015, Harbage Consulting has been supporting the California Department of Health Care Services (DHCS) in the implementation of the Drug Medi-Cal Organized Delivery System (DMC-ODS) Medicaid section 1115 waiver program.


This program aims to test a new paradigm for the organized delivery of 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’s work on behalf of DHCS includes:


  • Developing initial drafts of policy documents focused on key provisions of the Drug Medi-Cal waiver;
  • Vetting and resolving complex policy issues and providing background, analysis, and proposed options and recommendations for consideration;
  • Providing technical consultation, assistance, and support related to key policy issues, including federal Certified Public Expenditure (CPE) claiming and settlement protocols, addressing the terms and conditions of the waiver, and applicability of managed care rules; and
  • Providing project management support and facilitating meetings with the DHCS leadership team.


For more information about our work and results, see our DMC-ODS Case Study.

California’s Coordinated Care Initiative

Following our work in 2011 to help the Department of Health Care Services (DHCS) design the Coordinated Care Initiative (CCI)– including the financial alignment demonstration project Cal MediConnect and Medi-Cal Managed Long-Term Services and Supports (MLTSS) – Harbage Consulting was asked to support implementation of the CCI. Our implementation support falls into two categories:


Ensuring Program Sustainability:

  • Engaging and educating a wide-range of providers and advocates about the CCI program and how to talk to beneficiaries about what the program means for them. We conduct presentations, trainings, train-the-trainer sessions, lunch n’ learns, webinars, and provider-specific toolkits and materials;
  • Organizing widely-attended forums to facilitate communication between health plans and provider organizations, identifying operational issues, showcasing best practices, developing solutions, and encouraging providers to explore new ideas on how to improve care for beneficiaries;
  • Educating beneficiaries through direct outreach, facilitating telephone-town hall meetings, the development of consumer-facing education materials, including fact sheets, presentations, informational toolkits, and a consumer-friendly website; and
  • Staffing a team of on-the-ground outreach coordinators from across the state in CCI counties to build relationships and work closely with other local beneficiary resources.


Program Operations:

  • Designing and facilitating a best practices process for health plans participating in CCI to share lessons learned – from targeting care coordination to high-risk beneficiaries to improving referrals for long-term services and supports to connecting members with affordable housing and social supports;
  • Supporting the development of revised policy documents, memorandums of understanding, and other foundational documents as the program evolves;
  • Developing a proposed program performance dashboard, including analyzing various quality and demographic measures;
  • Designing and facilitating work groups around specific program implementation issues, including updating health risk assessment questions, transitioning MSSP; and
  • Developing strategy and policy options memos to help the state continuously improve the program.

Medi-Cal 2020 Waiver Implementation – Learning Collaboratives

Harbage Consulting provides ongoing support to the Department of Health Care Services (DHCS) on the two key programs that are included in the state’s Medi-Cal 2020 Section 1115 waiver, which was approved in December 2015.


Public Hospital Redesign and Incentives in Medi-Cal (PRIME)

Since January 2016, Harbage Consulting has worked closely with DHCS to build upon their first delivery system reform incentive payment (DSRIP) program to develop the Public Hospital Redesign and Incentives in Medi-Cal (PRIME) program. We assisted the state in designing the application and selection criteria for PRIME and are managing the planning and execution of the PRIME Learning Collaborative. Specifically, our support includes:


  • Providing strategic planning advice and structuring a curriculum for the Learning Collaborative;
  • Working closely with DHCS to ensure alignment with priorities for PRIME implementation;
  • Working directly with the 54 public hospitals that were selected to receive PRIME funding to identify their technical assistance needs;
  • Managing an advisory committee tasked with providing feedback and advice about the direction of the Learning Collaborative; and
  • Planning and executing webinars and in-person meetings for the PRIME entities to come together for shared learning.


See PRIME: Continuing California’s Delivery System Transformation for additional details about the program.



Whole Person Care Learning Collaborative

The Whole Person Care (WPC) pilot program was created as part of the Medi-Cal 2020 waiver to give  counties the opportunity to establish an infrastructure to provide enhanced care coordination and social supports to at-risk Medi-Cal beneficiaries.


Harbage Consulting is designing and facilitating the WPC Learning Collaborative on behalf of DHCS, bringing the lead entities and their partners together to exchange ideas, discuss their challenges, and identify best practices. Our work in leading the WPC Learning Collaborative includes:

  • Providing strategic advice and assisting with curriculum development;
  • Leading topic-specific Affinity Groups focused on key issues for the Pilots;
  • Planning and executing large scale, statewide, in-person convenings for the WPC lead entities and their partners;
  • Organizing webinars and facilitating presentations from state and national experts; and
  • Providing a continuous feedback loop for DHCS to help inform their administration of the program.


See The Whole Person Care Pilot Program: County Partnerships to Improve the Health of Medi-Cal Beneficiaries for details about the program.

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