To: Board of Supervisors
From: Dr. Grant Colfax, Health Services Director
Report Title: Amendment #23-773-6 with Health Management Associates, Inc.
☒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 Agreement #23-773-6 with Health Management Associates, Inc., a corporation, effective September 1, 2025, to amend Contract #23-773-2 (as amended by #23-773-3 through #23-773-5), to increase the payment limit by $1,770,000, from $2,050,000 to a new payment limit of $3,820,00 and extend the termination date from September 30, 2025 through September 30, 2026.
FISCAL IMPACT:
Approval of this amendment will result in additional annual expenditures of up to $1,770,000 and will be funded by 100% Contra Costa Health Plan Enterprise Fund II as budgeted by the department in FY 2025-26.
BACKGROUND:
Health Management Associates, Inc has been providing actuarial services to the Contra Costa Health Plan (CCHP) since October 2022. The contractor’s services include analysis of CCHP historical claims data to determine the required Incurred But Not Reported reserves (IBNR), assist in the completion of the annual Rate Development Template (RDT) deliverable to the State and provide comprehensive analysis of premium rating files from the State.
On August 15, 2023, the Board of Supervisors approved Contract #23-773-2 with Health Management Associates, Inc., in an amount not to exceed $300,000 to provide actuarial consulting services for the Contra Costa Health Plan, for the period from October 1, 2023 through September 30, 2024.
On February 27, 2024, the Board of Supervisors approved Amendment Agreement #23-773-3 to increase the payment limit by $300,000 from $300,000 to a new payment limit of $600,000 with no change in the term of October 1, 2023 through September 30, 2024.
On September 10, 2024, the Board of Supervisors approved Amendment Agreement #23-773-4 to increase the payment limit by $250,000 from $300,000 to a new payment limit of $850,000 and extend the term from September 30, 2024 to September 30, 2025.
On December 3, 2024, the Board of Supervisors approved Amendment Agreement #23-773-5 to increase the payment limit by $1,200,000 from $850,000 to a new payment limit of $2,050,000 with no change in the term through September 30, 2025.
Approval of Contract Amendment Agreement #23-773-6 will allow the contractor to provide additional actuarial consulting services related to the current Prospective Payment System and the State CalAIM and a Single Plan Medi-Cal Model in Contra Costa County, through September 30, 2026.
CONSEQUENCE OF NEGATIVE ACTION:
If this amendment is not approved, CCHP will not have the actuarial services required to meet State requirements with regard to CalAIM.