PRIME Projects

The seventeen projects included in the Public Hospital Redesign and Incentives in Medi-Cal (PRIME) program are organized into three domains, each of which has a different focus, and supports and complements the others.

Outpatient Delivery System Transformation and Prevention

These seven projects emphasize preventive services and the early diagnosis and treatment of illnesses.  Domain 1 projects also encourage empowering patients and equipping them with additional tools through access to behavioral health care, social supports, and other well-being needs.

Required for public health care systems:

• Integration of Physical and Behavioral Health (expanded details here)
• Ambulatory Care Redesign: Primary Care
• Ambulatory Care Redesign: Specialty Care

Public health care systems must also select at least one other Domain 1 project from the list below:

• Patient Safety in the Ambulatory Setting
• Million Hearts® Initiative
• Cancer Screening and Follow-up
• Obesity Prevention and Healthier Foods Initiative

Targeted High-Risk or High-Cost Populations

The second domain is focused on patients who would benefit most significantly from improved care integration and alignment, especially during the transition from inpatient to outpatient care, and in post-acute settings.

Required for public health care systems:

• Improved Perinatal Care
• Care Transitions: Integration of Post-Acute Care
• Complex Care Management for High Risk Medical Populations

Public health care systems must also select at least one other Domain 2 project from the list below:

• Integrated Health Homes for Foster Children
• Transition to Integrated Care: Post Incarceration.
• Chronic Non-Malignant Pain Management
• Comprehensive Advanced Illness Planning and Care

Resource Utilization Efficiency

The third domain seeks to reduce the ineffective and potentially harmful overuse, misuse, and inappropriate underuse of various diagnostics and treatments.

Public health care systems must choose at least one of the following projects:

• Antibiotic Stewardship
• Resource Stewardship: High Cost Imaging
• Resource Stewardship: Therapies Involving High Cost Pharmaceuticals
• Resource Stewardship: Blood Products

• See an example project
• Read our Issue Brief on the PRIME program
• Read more about the Medi-Cal 2020 waiver
• Read about PRIME’s successor, the 2010-2015 Delivery System Reform Incentive Program (DSRIP)
• See the State of California’s PRIME page which includes the Special Terms and Conditions of the waiver and relevant attachments

CAPH members can access more resources and technical assistance related to PRIME through SNI Link.