Coordinated performance measurement and improvement efforts in California's safety net systems: early experience and lessons

Introduction Safety-net health systems often lack incentives and resources to support performance measurement and improvement activities. The California Delivery System Reform Incentive Program (DSRIP) is a pay-for-performance initiative that incentivizes the state’s public health care systems to improve quality of care. Health system participants must report on metrics in both inpatient and outpatient settings. To enhance DSRIP participants’ capacity to engage in (1) best practices to improve quality of care and (2) reporting of DRSIPrequired metrics, the California Association of Public Hospitals and UCSF established the Public Healthcare systems Evidence Network and Innovation eXchange (PHoENIX), with funding from AHRQ. PHoENIX priorities are meeting the HEDIS Medicare PPO 90 percentile thresholds for mammography screening (76.6%) and cholesterol control (LDL-C) for diabetes (<100 mg/dl, 62.2%).