To: Board of Supervisors
From: Dr. Grant Colfax, Health Services Director
Report Title: Contract Amendment #27-530-13 with BASS Medical Group
☒Recommendation of the County Administrator ☐ Recommendation of Board Committee
RECOMMENDATIONS:
APPROVE and AUTHORIZE the Health Services Director, or designee, to execute on behalf of the County Contract Amendment #27-530-13 with BASS Medical Group, a corporation, effective July 1, 2026, to amend Contract #27-530-11 (as amended by Contract Amendment #27-530-12), to include the Dual Eligible Special Needs Plan (D-SNP) obligations and requirements, authorizing the Contractor to provide specialized care to beneficiaries who are dually eligible for Medicare and Medi-Cal and to offer care coordination and wrap around services, with no change in the payment limit of $21,600,000 or term ending in June 30, 2027.
FISCAL IMPACT:
Approval of this Contract Amendment will not result in any additional fiscal impact and will remain budgeted by the department and funded 100% by Contra Costa Health Plan (CCHP) Enterprise Fund II revenues. (No rate increase)
BACKGROUND:
CCHP has an obligation to provide certain PCP, Medical Specialist Provider and Non-Physician Provider services including but not limited to; urgent care, pulmonary care, neurology, gastric bypass, gastroenterology, podiatry, diagnostic imaging, laboratory, and other surgical services for its members under the terms of their Individual and Group Health Plan membership contracts with the County. In January 2022, the Department of Health Care Services (DHCS) implemented its California Advancing and Innovating Medi-Cal (CalAIM) initiative, part of which requires all Medi-Cal Managed Care Plans to have a D-SNP line of business as of January 1, 2026, unless determined otherwise by the DHCS exemption process. D-SNPs are Medicare Advantage (MA) plans that provide specialized care to beneficiaries dually eligible for Medicare and Medi-Cal and offer care coordination and wrap-around services. To comply with the DHCS mandate to implement a D-SNP line of business, CCHP is required to achieve network adequacy of its Provider Network.
This Contract is entered into under and subject to the following legal authorities: California Government Code §§ 26227 and 31000; Health and Safety Code § 1451. Health Services Personnel approved this Contract to ensure no conflicts with labor relations. Contractor currently cooperates and participates in CCHP’s Quality Management Program which consists of quality improvement activities to improve the quality of care, services and member experience. Cooperation includes collection and evaluation of performance measurement data and participation in the organization’s clinical and service measure Quality Improvement Programs. This Contractor has been a part of the CCHP Provider Network providing services and fostering a deep understanding of the CCHP organizations mission, values, and long-term objectives since May 2002.
On July 23, 2024, the Board of Supervisors approved Contract #27-530-11 with BASS Medical Group, in an amount not to exceed $21,000,000, for the provision of PCP, Medical Specialist Provider and Non-Physician Provider services including urgent care, surgery, specialty medical, pulmonary, neurology, gastroenterology, podiatry, therapy, laboratory and diagnostic imaging services for CCHP members and County recipients, for the period July 1, 2024 through June 30, 2027.
On January 21, 2025, the Board of Supervisors approved Contract Amendment #27-530-12 with BASS Medical Group, effective January 1, 2025, to increase the payment limit by $600,000 to a new payment limit of $21,600,000 to provide additional Primary Care Physicians, Medical Specialist Provider and Non-Physician Provider services and include a Pay for Performance incentive with no change in the term through June 30, 2027. This value-based payment was added for Pay for Performance incentives based on the provider group's performance on a set of Healthcare Effectiveness Data and Information Set (HEDIS) and other quality measures outlined in the annual Pay for Performance Incentive Program Guide located on the CCHP website.
Approval of Contract #27-530-13 will allow the Contractor to continue providing services for CCHP members and County recipients who are dually eligible for Medicare and Medi-Cal and will support CCHP’s compliance with DHCS mandates and CMS network adequacy standards through June 30, 2027. This Contract was delayed due to extended Contract negotiations between the Division and Contractor.
CONSEQUENCE OF NEGATIVE ACTION:
If this Contract Amendment is not approved, CCHP not be compliant with DHCS requirements and beneficiaries dually eligible for Medicare and Medi-Cal will not receive additional services.