Delivery System Reform Incentive Program (DSRIP)

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DOWNLOAD THE FULL REPORT HERE – Individual member briefs are located below.

In 2010, California’s 21 public health care systems (PHS) took a bold and collective step to transform and streamline their complex delivery systems through a new federal pay-for-performance initiative. This initiative, called the Delivery System Reform Incentive Program (DSRIP), was the first of its kind in the nation. Since then, the Centers for Medicare and Medicaid Services (CMS) have approved DSRIPs in several other states.

The DSRIP was part of the package of programs that comprised California’s 2010 Medicaid Waiver, titled “The Bridge to Reform.”

The word “reform” in this case referred to the changes coming to American health care thanks to the Affordable Care Act (ACA). The waiver included two core components – the DSRIP and the Low Income Health Program (LIHP) – both of which were critical to California’s leadership role in ACA implementation, and both of which had a considerable focus on expanding access to care.


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But true reform is not a destination, it is a path. True reform is a much larger and more complicated goal than can be accomplished in five years.

True reform is itself a bridge – leading away from a purely reactive way of doing business and toward a model of integrated care that is high value, high quality, patient-centered, efficient and equitable, with an emphasis on patient experience and a demonstrated ability to improve health care and the health status of populations.

While access is certainly a cornerstone of that bridge, it is still only part of a structure that also includes changes in process and culture and a stronger emphasis on results.

To more fully understand where and how that bridge must take California’s PHS, we must first understand how far we have come. The 2010 DSRIP has enabled California’s PHS to build a solid foundation for continuous delivery system improvement. This brief is intended to help illustrate how California’s DSRIP has already resulted in markedly improved processes and health outcomes for patients.

Read about the transformations that took place at each of our member systems:

Alameda Health System
Arrowhead Regional Medical Center
Contra Costa Regional Medical Center & Health Services
Kern Medical Center
Los Angeles County Department of Health Services
Natividad Medical Center
Riverside County Regional Medical Center
San Francisco General Hospital & Trauma Center
San Joaquin General Hospital
San Mateo Medical Center
Santa Clara Valley Medical Center
UC Davis Medical Center
UC Irvine Medical Center
UCLA Health
UC San Diego Health System
UC San Francisco Medical Center
Ventura County Health Care Agency

Watch our video on the impact DSRIP has had across the state.