Observations From California's Delivery System Reform Incentive Payment Program.

California's Delivery System Reform Incentive Payment (DSRIP) Program provided $3.3 billion over 5 years to support 21 public hospitals improve the quality of health care delivery and population health. The Institute for Population Health Improvement provided technical support and quality improvement mentorship to the California Department of Health Care Services in implementing the DSRIP Program. This report describes the following key observations on the implementation of the program: the need to reduce variability in data collection and management, memorialize decision-making processes, build broad quality improvement capacity, define and revisit improvement targets, anticipate evolution of clinical definitions and guidelines, provide frequent feedback to participating hospitals, engage frontline clinicians, balance short- and long-term improvement goals, acknowledge regulatory requirements and improvement efforts that may compete for resources, and build in shared learning and dissemination of interventions. The authors believe this experience with implementing California's DSRIP Program may assist other states as they implement similarly intended reform programs.