The Medi-Cal 2020 Global Payment Program (GPP): A New Approach to Safety Net Funding for Public Hospital Counties

Authors: Lucy Pagel and Jennifer Ryan

Prepared with support from The California Endowment

March 2016 – This fact sheet describes California’s Global Payment Program (GPP), which was approved on December 30, 2015, as part of California’s Medi-Cal 2020 section 1115 waiver. The GPP is a commitment from the federal Centers for Medicare & Medicaid Services (CMS) to the California Department of Health Care Services (DHCS) to provide ongoing funding to support the 13.6% of Californians who remain uninsured. The stated goals of the GPP are to: 1) Move away from payments restricted to hospital settings; 2) Encourage the use of primary and preventive services and create access to services like telehealth, group visits, and health coaching by expanding the settings in which PHCSs can receive payments; 3) Emphasize coordinated care and care provided outside of the hospital and emergency room; and 4) Recognize the value of services that have not typically been reimbursable through Medicaid, but that substitute or compliment services that are reimbursable. These GPP goals are critical to the long term viability of the program and will help to frame the role of the GPP in expanding access to care for California’s remaining uninsured.