Photo: Ventura County Health Care Agency


The Global Payment Program (GPP) is the first payment reform effort of its kind for the remaining uninsured, aimed at encouraging primary and preventive care.

Despite the progress made under the Affordable Care Act, the UC Berkeley Center for Labor Research and Education estimates that by the year 2019, three million Californians will remain uninsured.

These individuals have historically had limited access to primary and preventive services, often only seeking emergency health care services when their conditions have become more advanced. And though many Californians have health insurance, they may not be covered for certain services that are critical to their health and well-being.


The Global Payment Program reorganizes existing funding streams to create financial incentives for California’s public health care systems to provide these uninsured and underinsured individuals with more appropriate care in outpatient settings. The GPP’s incentives also encourage public health care systems to offer new services that were previously unreimbursed, but which have been shown to help improve health outcomes, including health coaching, nurse advice lines, technology-based visits and more.

The GPP is a 5-year pilot initiative included as part of California’s Medi-Cal 2020 waiver, and is intended to complement other delivery system transformation efforts that are also focused on strengthening primary and specialty outpatient care. If successful, the combined result of all of these efforts will be redesigned public safety-net delivery systems that provide the right care in the right place at the right time, regardless of how – or whether – a patient is insured.

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