A Quality Strategy to Advance the Triple Aim in California’s Medicaid Program

Desiree R. Backman, Neal D. Kohatsu, Orion T. Stewart, Rachel L. Barrington, Kenneth W Kizer

Research output: Contribution to journalArticlepeer-review


The California Department of Health Care Services (DHCS) administers the nation’s largest Medicaid program. In 2012, DHCS developed a Quality Strategy modeled after the National Quality Strategy to guide the Department’s activities aimed at advancing the Triple Aim. The Triple Aim seeks to improve the patient experience of care and the health of populations as well as reduce the per capita cost of health care. An academic team was contracted to assist DHCS in developing the strategy, which also was informed by extensive stakeholder input, an advisory committee, and a comprehensive inventory of DHCS quality improvement (QI) activities. From 2012 to 2018, the strategy included 129 unique QI activities. Most activities were intended to deliver more effective, efficient, affordable care or to advance disease prevention. This qualitative assessment of the DHCS Quality Strategy provides insights that may inform other Medicaid programs or large health systems as they develop quality strategies.

Original languageEnglish (US)
JournalAmerican Journal of Medical Quality
StatePublished - Jan 1 2019


  • health care delivery
  • health care reform
  • quality improvement
  • strategic planning

ASJC Scopus subject areas

  • Health Policy


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