To: Joint Conference Committee (JCC) Members
From: Beth Hernandez, Quality and Health Equity Director, Contra Costa Health Plan
Date: October 3, 2025
Subject: Quality & Health Equity Update
Recommendation
Receive an informational report on Contra Costa Health Plan’s (CCHP) Quality and Health Equity program activities, recent accomplishments, and focus areas.
Background
The Quality and Health Equity Department at CCHP is responsible for monitoring and improving the quality of care delivered to our members, advancing health equity across populations, and supporting the organization’s population health efforts. The department manages quality measurement and reporting, oversees accreditation, implements data-informed interventions to address disparities and improve outcomes, delivers health education to promote prevention and wellness, and ensures access to culturally and linguistically appropriate services. Staff collaborate across departments, with providers, and in community organizations to ensure care delivery aligns with the needs of CCHP’s diverse membership.
Key Accomplishments and Highlights
CCHP submitted its Measurement Year (MY) 2024 Healthcare Effectiveness Data and Information Set (HEDIS) in June 2025. These measures are used by a variety of regulators for enforcement purposes. CCHP anticipates earning back 100% of capitation dollars (totaling approximately $6 million) for CY 2024 through Department of Health Care Services (DHCS) Quality Withhold program. CCHP surpassed the Department of Health Care Services (DHCS) Minimum Performance Level (MPL) for all Medi-Cal Accountability Set (MCAS) Measures in 2024 and will not receive any sanctions.
The National Committee on Quality Assurance (NCQA) just released the 2025 Health Plan Ratings, and CCHP received 4.5 Stars, placing CCHP as 1 of 3 Medicaid plans in California with 4.5 Stars (the other two being Kaiser Permanente North and South). CCHP is 1 of 14 in Medicaid Plans in the country to receive this rating.
Corrective Actions and Improvement Initiatives
The Department of Managed Health Care (DMHC) released its findings for the MY2023 Health Equity and Quality Measure Set (HEQMS). This is a new quality measurement reporting set the evaluates whether each racial and ethnic group meets or exceeds the minimum performance level for a set of measures. Several racial and ethnic groups were below the minimum performance level for Hemoglobin A1c Control and Poor Control, Controlling High Blood Pressure, and Well Care Visit Measures. While this CAP was just issued, our MY2024 results show that most of the deficiencies have been corrected in our MY2024 rates, and remaining issues are related to Well Care Visits. CCHP has a performance improvement project focusing on improving well care visits for Native Hawaiian and Pacific Islander and Black/African American populations.
Current Priorities and In-Progress Work
Current departmental priorities focus on completing preparations for the upcoming NCQA Health Plan and Health Equity Accreditation surveys, advancing D-SNP readiness for the January 2026 launch, and implementing quality-based pay for performance payment arrangements with provider groups. Outreach efforts continue to support preventive care, behavioral health follow-up, and chronic disease management. Staff are actively engaged with providers and community partners to improve member experience, address health disparities, and ensure that educational and outreach programs reach priority populations. Additionally, the department is preparing for year-end performance improvement projects, maternal health initiatives, and the collection and reporting of D-SNP Star measures.
Challenges
The department’s primary challenge this quarter is completing NCQA Health Plan and Health Equity Accreditation preparations and implementing pay for performance payment arrangements with provider groups while the Dual Eligible Special Needs Plan (D-SNP) project continues to demand significant focus and resources. Preparing for accreditation requires intensive documentation, workflow reviews, and coordination across multiple departments. At the same time, CCHP is advancing large-scale initiatives such as the launch of the D-SNP. Ensuring these major projects progress concurrently requires careful prioritization, resource allocation, and sustained cross-department collaboration.
Looking Ahead
In the coming quarter, key milestones include submitting the Health Plan Accreditation deliverables in December, advancing year-end performance improvement projects, and preparing maternal health and behavioral health collaborative initiatives. The department will continue transitioning provider contracts to incorporate pay-for-performance incentives and begin preparing for D-SNP Star measures to ensure strong quality and member experience outcomes. CCHP is also working on transitioning to digital quality measures and incorporating Medi-Cal Connect data sources into population health initiatives. These efforts will be coordinated alongside ongoing routine quality monitoring, preventive care outreach, and equity-focused interventions.