Advisory Board: Contra Costa Health Plan Joint Conference Committee
Subject: 2026 Organizational Priorities
To: Joint Conference Committee (JCC) Members
From: Irene Lo, MD FACS; Chief Executive Officer (Interim)
Date: December 19, 2025
Subject: 2026 Organizational Priorities
This report provides an overview of CCHP’s strategic direction for 2026, outlining the organizational priorities, focus areas, and foundational work that will guide our transformation efforts over the next year. It is intended to support shared understanding, alignment, and oversight as CCHP strengthens its role as a Managed Care Plan and within the Contra Costa Health integrated delivery system.
2025 YEAR IN REVIEW - INTRODUCTION
2025 was a foundational and transformative year for Contra Costa Health Plan (CCHP). Over the past twelve months, the organization strengthened core infrastructure, clarified leadership roles, assessed organizational needs, and deepened alignment with the broader Contra Costa Health (CCH) integrated delivery system.
A comprehensive Strength Weakness Opportunities and Threat (SWOT) analysis highlighted opportunities to improve workflow efficiency, cross-departmental coordination, data utilization, internal communication, fiscal literacy, regulatory compliance, and governance. These insights underscored the need for enhanced alignment, standardized processes, and a stronger culture of accountability across the Plan.
Alvarez & Marsal (A&M) also conducted a comprehensive analysis of CCHP’s organizational structure. Their review highlighted opportunities to align with industry best practices, more clearly define roles and responsibilities, clarify expectations of leadership, and establish more appropriate spans of control. Coupled with A&M’s previous operational assessment, this structural review provided CCHP with a deeper and more detailed understanding of organizational strengths and opportunities for enhancement, further informing CCHP’s modernization path.
At the system level, Contra Costa Health welcomed new departmental leadership, bringing clearer expectations and renewed alignment across the enterprise. During this period, CCHP also built stronger relationships with key delivery system partners-including CCRMC/Health Centers, Public Health, Behavioral Health, and Health, Housing & Homeless Services (H3)-reinforcing collaboration and accelerating systemwide coordination.
Together, these assessments, leadership transitions, strengthened partnerships, and early modernization efforts laid the groundwork for CCHP’s 2026 organizational priorities and strategic direction.
2026 ORGANIZATIONAL PRIORITIES
Contra Costa Health Plan (CCHP) is entering a pivotal phase of transformation driven by new regulatory expectations, fiscal pressures, and organizational realignment. As we prepare for the launch of the Dual Eligible Special Needs Plan (D-SNP) in 2026 and respond to federal statewide policy and funding changes, our focus remains on strengthening the Plan’s governance, regulatory compliance, operational effectiveness, and long-term financial sustainability.
To meet these challenges, CCHP must modernize its infrastructure, processes, and systems to operate as a nimble, data-driven, and high-performing managed care organization. A recent Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis has revealed significant opportunities for improvement-particularly in areas such as workflow efficiency, cross-departmental coordination, data utilization, internal communication, fiscal literacy, regulatory compliance, and governance. These findings underscore the need for stronger alignment, education, and accountability across all functions to ensure that operations, decision-making, and oversight fully support CCHP’s mission and financial sustainability.
Over the next year, CCHP’s work will be guided by a clear set of strategic priorities designed to reinforce accountability, enhance collaboration, and modernize operations within the Contra Costa Health integrated delivery system. These priorities include:
Fiscal Transparency and Accountability - Enhancing financial oversight and operational alignment through clear reporting, collaborative budgeting, and disciplined cost management.
Responding to Federal and State Fiscal Challenges (HR1 and the California State Budget) - Proactively assessing and mitigating the impact of policy and funding changes to maintain organizational stability and safeguard member services.
Strengthening Collaboration with CCRMC and Health Centers - Driving improvements in quality, access, and care coordination while achieving measurable cost savings and long-term system sustainability.
Engaging with Peer Managed Medi-Cal Plans - Working directly and collaboratively with leadership at other managed Medi-Cal plans and statewide associations such as Local Health Plans of California (LHPC) and California Association of Health Plans (CAHP) to align advocacy efforts, share best practices, and promote coordinated systemwide improvements.
Implementing Organizational Changes - Executing Alvaraz and Marsal’s (A&M) recommendations to establish a leaner, more effective organizational model that enhances accountability, operational efficiency, and cost containment, supporting long-term financial stability and sustainable growth.
These priorities can be further condensed into three major strategic focus areas:
Strengthening governance, fiscal transparency, and accountability
Enhancing regulatory compliance and audit readiness
Improving operational efficiencies-particularly in provider and vendor contracting, utilization management, and claims processing
Through disciplined execution, transparent reporting, modernization of core systems, and close collaboration across departments, CCHP will continue to strengthen its foundation as a high-performing public health plan-responsive to our members, our providers, and the evolving health care landscape across California.
PERFORMANCE IMPROVEMENT WORKGROUPS (PIWs)
To support CCHP’s 2026 organizational priorities and strengthen accountability across the Plan, CCHP has formally launched Performance Improvement Workgroups (PIWs). These workgroups are designed to accelerate operational improvements, enhance cross-departmental coordination, and provide a structured forum for solving systemwide challenges. These workgroups will also work in parallel to and in coordination with Contra Costa Health Division-level Performance Improvement Workgroups to support system-wide alignment.
Each PIW is supported by CCHP’s Project Management Office (PMO) and anchored in clear charters, defined roles, timelines, and measurable objectives. PIWs are responsible for identifying root causes, executing solutions, and providing regular updates to executive leadership and CCHP’s Performance Improvement Workgroup Steering Committee.
These PIWs provide a disciplined, consistent structure for issue resolution, project execution, and systemwide alignment. They will serve as a critical mechanism for operationalizing CCHP’s strategic priorities in 2026.
DASHBOARDS AND REPORTING INFRASTRUCTURE
As part of CCHP’s modernization efforts, the organization is developing a suite of enterprise-level dashboards to enhance transparency, strengthen accountability, and support data-driven decision-making.
These dashboards are designed to provide leaders with consistent and timely visibility into key metrics across financial performance, member experience, operations, quality, and regulatory readiness. They incorporate standardized data definitions, clear performance thresholds, and alignment with state and federal reporting requirements.
These dashboards will support executive decision-making, facilitate PIW oversight, and ensure visibility into performance trends across the organization. They also reinforce CCHP’s commitment to transparency, operational excellence, and regulatory readiness.
Risks and Mitigation
As CCHP prepares for an intensive operational and regulatory year in 2026, several enterprise-level risks require active monitoring and coordinated mitigation. The following summarizes the most significant risks and the strategies in place to address them:
Regulatory Oversight and Audit Readiness
Risk: CCHP will undergo multiple major reviews in 2026, including the DMHC Financial Audit, the DMHC Follow-up Medical Survey, the DHCS Medical Audit, NCQA Health Plan Accreditation, and ongoing CMS/DHCS monitoring for the D-SNP launch. These audits carry operational, financial, and reputational implications.
Mitigation:
Strengthening policy management, delegation oversight, and internal monitoring
Conducting internal mock audits and readiness reviews
Maintaining proactive communication with NCQA, DHCS, DMHC, and CMS
Deploying the Compliance PIW to coordinate audit preparation and issue resolution
Workforce Stability and Recruitment Challenges
Risk: Ongoing recruitment challenges impact operational stability and increase regulatory and financial risk.
Mitigation:
Accelerated recruitment for high-priority roles, including interim subject matter experts as bridge coverage
Launching FY 2026-2027 position modifications to stabilize staffing
Strengthening spans of control, onboarding, and internal training
Deploying PMO and PIWs to examine opportunities to strengthen labor and workforce
Financial Pressures Tied to HR1 and State Budget Uncertainty
Risk: Federal HR1 provisions and California state budget constraints may impact Medi-Cal funding, administrative allocations, and rate structures, posing risks to long-term financial sustainability.
Mitigation:
Enhanced financial modeling, forecasting, and scenario planning
Strengthening cost-containment strategies across UM, claims, and network management
Active participation in LHPC and CAHP advocacy efforts
Operational Integration and Systems Readiness
Risk: Modernizing systems and workflows remains complex, particularly across claims, UM, member services, and Medicare/Medi-Cal integration. Delays or inconsistencies may affect compliance, member experience, and financial performance.
Mitigation:
Standardization of project workflows, systems testing, and process redesign
Comprehensive dashboard development to improve visibility and decision-making
PIW structure to support cross-functional integration and eliminate operational silos
Strengthened collaboration with CCH Information Technology partners
CONCLUSION
CCHP enters 2026 with a stronger foundation, clearer priorities, and a more unified direction than at any point in recent years. The work completed throughout 2025-organizational assessments, strengthened partnerships across Contra Costa Health, establishment of the PMO, creation of Performance Improvement Workgroups, and the development of transparent reporting tools-has positioned the Plan to navigate a complex regulatory landscape and deliver improved outcomes for members, providers, and the broader community.
The year ahead will require discipline, collaboration, and a continued commitment to modernization. By focusing on fiscal transparency, regulatory readiness, operational efficiency, and deeper integration with CCRMC/Health Centers and other system partners, CCHP is well-positioned to strengthen its performance as a Managed Care Plan and to support Contra Costa Health’s mission of advancing quality, equity, and sustainability across the delivery system.
Through the collective efforts of our teams, the guidance of our leadership, and the support of our partners, CCHP will continue to evolve into a more accountable, data-driven, and high-performing public health plan-prepared to meet the needs of our members today and ready to succeed in the rapidly changing healthcare landscape of tomorrow.