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CONTACT: Bridget Kelly
Director, Communications 714-246-8765


Health and Wellness Community Event will honor agency’s legacy of quality, cost-effective care

ORANGE, Calif. (October 1, 2015) — Twenty years ago, on October 1, 1995, 180,000 low-income Orange County residents became the first members of CalOptima, a new managed care system for Medi-Cal. At the time, CalOptima was created as a local solution to fix the crisis in access to Medi-Cal services that was causing overcrowded emergency rooms and unnecessary costs.

Two decades have transformed CalOptima into a statewide model of quality
and efficiency for a membership of more than 750,000. This past month,
CalOptima received an overall quality rating of 4 out of 5 in the National
Committee for Quality Assurance’s Medicaid Health Insurance Plan Ratings 2015–2016. This is the second year in a row that CalOptima is the leader in California among NCQA-reviewed plans. CalOptima also leads in cost-effectiveness, with an administrative cost ratio of 3.98 percent, the lowest among county organized health systems in California for 2014. Keeping administrative costs low means CalOptima can spend more money on health care services for members.

“CalOptima draws strength from our community and provider partnerships developed over 20 years,” says Michael Schrader, Chief Executive Officer. “Since 1995, CalOptima members have had access to thousands of quality health care providers through a locally controlled, public-private partnership. Our public agency together with the private health networks share the goal of improving health in Orange County, which has enabled us to reach this anniversary milestone.”

In recognition of the 20th anniversary, CalOptima plans a yearlong celebration. The main event will be a Health and Wellness Community Event next month at CalOptima’s offices in Orange. Members and the community are invited to attend to receive health screenings, wellness information, family resources and more. The event will also feature cultural entertainment that reflects CalOptima’s diversity.



Celebrating 20 Years

CalOptima Health and Wellness Community Event Saturday, November 14, 2015 10 a.m. to 2 p.m.

| Orange, CA 92868 |

505 City Parkway West
Main: 714-246-8400 | Fax: 714-246-8492 | TDD/TTY: 800-735-2929

Established 20 years ago, CalOptima’s mission is “to provide members with access to quality health care services delivered in a cost-effective and compassionate manner.” The member-centered mission has been a steady guidepost, pointing the way forward amid the changing health care environment. For example, CalOptima played an important role in serving the uninsured in Orange County after the implementation of the Affordable Care Act expanded Medi-Cal eligibility. In addition, CalOptima’s support for members also led to the launch of several programs across 20 years:

1995: Medi-Cal — California’s Medicaid program offering health insurance for low-income children, adults, seniors and people with disabilities

2001: Multipurpose Senior Services Program — Social and health care management services to delay seniors from having to go to nursing homes

2005: OneCare (HMO SNP) — A Medicare Advantage Special Needs Plan for low-income seniors and people with disabilities who qualify for both Medicare and Medi-Cal

2013: Program of All-Inclusive Care for the Elderly (PACE) — A community-based program for older adults, providing comprehensive health services through the CalOptima PACE center

2015: OneCare Connect Cal MediConnect Plan (Medicare-Medicaid Plan) — A pilot program that combines Medicare and Medi-Cal benefits and promotes coordinated health care

“In 2013, CalOptima’s Board of Directors set a vision: To be a model public agency and community health plan that provides an integrated and well-coordinated system of care to ensure optimal health outcomes for all our members,” says Mark Refowitz, Chairman of the CalOptima Board of Directors. “Our two newest programs reflect progress toward that vision. PACE offers compassionate, community- based health care to support the independence of seniors, while OneCare Connect improves outcomes by bringing together all benefits and coordinating care. CalOptima’s next decades are sure to bring more promising innovations to better the health of Orange County’s vulnerable residents.”

To learn more about CalOptima’s anniversary celebration, visit ###

About CalOptima

A county organized health system, CalOptima provides publicly funded health care coverage for low-income children, adults, seniors and people with disabilities in Orange County, Calif. CalOptima’s mission is to provide members with access to quality health care services delivered in a cost-effective and compassionate manner. In total, CalOptima serves more than 750,000 members with a network of more than 7,000 primary care doctors and specialists, as well as 30 hospitals.

505 City Parkway West | Orange, CA 92868 | Main: 714-246-8400 | Fax: 714-246-8492 | TDD/TTY: 800-735-2929

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