Press Release

Reflecting a longstanding commitment to quality, CalOptima is proud that the National Committee for Quality Assurance (NCQA) renewed the agency’s Medi-Cal accreditation for three years, through July 27, 2024. NCQA Accreditation means that health plan operations meet rigorous requirements for consumer protection and quality improvement. CalOptima received a perfect 100% score on its renewal review.

“Our members’ well-being is always our first priority,” said Supervisor Andrew Do, Chairman of the CalOptima Board of Directors and Chairman of the Orange County Board of Supervisors. “The NCQA accreditation affirms that CalOptima is fulfilling our mission to deliver access to quality health care for all Medi-Cal members. This achievement signals our commitment to fostering consistent, efficient service and high satisfaction.”

NCQA is the nation’s most trusted independent source for evaluating health care quality and the only assessment program that bases results on clinical performance and consumer experience. Earning accreditation as a Medi-Cal plan is voluntary at this time; however, a new state initiative known as California Advancing and Innovating Medi-Cal (CalAIM) will require this gold standard of all plans starting in 2027.

“CalOptima was first accredited in 2012, so for nearly a decade, the agency has shown an ability to maintain accreditation and stay focused on positive member experiences,” said Richard Sanchez, CalOptima CEO. “CalOptima shares this honor with our provider partners, who continually demonstrate their dedication to caring for Medi-Cal members. Quality drives our work every day.”

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, California. 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 842,000 members with a network of 9,200 primary care doctors and specialists as well as 42 acute and rehab hospitals.

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 more informed health care choices.