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This site visit explored aspects of health care delivery for Medicaid beneficiaries and the uninsured in a California county marked by a diverse population, dominant managed care, and stakeholder dedication to solving problems in a spirit of "coopetition." The program looked at the impact of California's Bridge to Reform (the state's Medicaid section 1115 waiver) on federally qualified health centers and the people they serve. Eligibility and enrollment expansions in the Low Income Health Program and Medi-Cal, health information technology adoption and its use to improve care delivery and health, and patient-centered medical homes and care coordination were discussed. The group learned about efforts to integrate behavioral health and social services into primary care and the identification of heavy health care users and system improvements to better serve them. Participants visited three community health centers, conversed with government officials, providers, a health plan representative, consumer advocates, leaders in health information technology, a hospital executive, and experts on the San Diego market. A report on participants' impressions was published on May 15, 2013.

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