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CalOptima Health Allocates Over Half a Billion to Boost Medicaid Rates in Orange County

Substantial funding increase aims to stabilize healthcare access and provider networks through 2026.

June 19, 2024  – CalOptima Health announced a funding increase designed to boost the pay rates for a broad array of healthcare providers within its network in Orange County, California. The organization’s board of directors approved $526.2 million aimed at increasing compensation for health networks, hospitals, physicians, community clinics, behavioral health provider, and ancillary service providers. This initiative is set to go into effect July 2024 and last for 30 months until December 2026, to bolster the long-term financial stability of the managed care network.

Serving nearly one-third of Orange County’s population, CalOptima Health hopes the funding will mitigate the longstanding issues surrounding the accessibility of critical healthcare services for its members. 

Michael Hunn, the CEO of CalOptima Health, highlighted that the investment would address historical challenges with Medi-Cal reimbursements which have often hindered patient and family access to necessary care. “Historically, Medi-Cal reimbursement rates have presented significant barriers to accessing needed care for patients and their families in our community,” she stated in a recent press release.

The funding will also enhance the network’s ability to provide timely healthcare services, ensuring that members receive the care they need without undue delays. CalOptima Health’s network, which includes 10,900 primary care providers and specialists, along with 39 acute and rehabilitation hospitals, is crucial in meeting the healthcare needs of a diverse and growing population.

This move by CalOptima Health is part of a broader strategy to improve healthcare outcomes by ensuring that care providers are adequately compensated. It also helps attract and retain the necessary workforce to meet demand. The organization’s commitment to its members and providers is reflective of its mission to provide high-quality, accessible healthcare services, thereby improving the overall health landscape in Orange County. 

To read the entire CalOptima Health press release, click here

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