Press Release

CalOptima Health is a top Medi-Cal plan in California, receiving a rating of 4 out of 5 in the National Committee for Quality Assurance (NCQA) Medicaid Health Plan Ratings 2022. This is the eighth year in a row that CalOptima Health has received this distinction. Medicaid is known as Medi-Cal in California, and no other Medi-Cal plan in the state earned higher than 4 out of 5.

“CalOptima Health’s mission is to serve member health with excellence and dignity,” said Michael Hunn, CEO of CalOptima Health. “The NCQA rating shows that we are fulfilling that mission no matter the challenges of the pandemic. Our provider partners have sustained their commitment to quality care for a remarkable eight years, and our community is healthier because of their dedication to members.”

NCQA assesses Medicaid plan quality based on 43 clinical measures related to both preventive care and treatments. Preventive measures report whether members get services to keep them healthy and treatment measures gauge whether members receive appropriate care in response to illnesses and chronic diseases. NCQA also evaluates a plan based on five customer satisfaction dimensions, such as getting care quickly and rating of health plan.

“Day in and day out, Orange County’s dedicated providers demonstrate the quality of care that’s possible through a community-based health plan,” said Richard Pitts, D.O., Ph.D., Chief Medical Officer. “By strictly focusing on doing what’s best for the member, we achieve our high-quality standards and make our ‘Better. Together.’ motto come alive.”

A county organized health system, CalOptima Health provides publicly funded health care coverage for low-income children, adults, seniors and people with disabilities in Orange County, California. CalOptima Health’s mission is to serve member health with excellence and dignity, respecting the value and needs of each person. In total, CalOptima Health serves more than 921,000 members with a network of more than 10,500 primary care doctors and specialists as well as 44 acute and rehab hospitals.

The NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations and recognizes clinicians in key clinical areas. NCQA’s HEDIS® is the most widely used performance measurement tool in health care. NCQA’s website ( www.ncqa.org ) contains information to help consumers, employers and others make informed health care choices.