To: Joint Conference Committee (JCC) Members
From: Irene Lo, MD FACS; Chief Executive Officer (Interim)
Date: October 3, 2025
Subject: Organizational Structure Analysis and Salary Survey
1. Organizational Structure Analysis
The purpose of this report is to provide an update on the organizational structure analysis conducted at Contra Costa Health Plan (CCHP). The analysis was performed at the direction of the JCC and initiated to review CCHP’s current organizational structure and identify opportunities for enhancement in leadership, departmental alignment, and operational efficiencies. The goal is to ensure that the organizational model supports best practices in managed care, prepares CCHP for future growth, and strengthens our ability to deliver high-quality, coordinated services.
Background
At the direction of the JCC, CCHP engaged the external consulting firm Alvarez & Marsal (A&M) to
partner with leadership in reviewing our organizational structure. The review assessed the current state of leadership roles, departmental design, and lines of accountability. The analysis also considered industry best practices and the evolving requirements of managed care, including CCHP’s preparation for new initiatives such as the Medicare-Medi-Cal Dual Special Needs Plan (D-SNP) launch.
Key Findings
• Organizational structure misalignment
• Inconsistent spans of control
• Unclear leadership title framework
• Staffing decisions not based on benchmarks
• County job classification system issues
A&M Recommendations
A&M provided several recommendations to strengthen CCHP’s organizational structure, including:
• Reorganization of leadership
• Adjustment of spans of control
• Title framework improvements
Next Steps
• Leadership will review and prioritize recommendations from A&M’s analysis.
• A phased implementation plan will be developed to address key enhancements in leadership roles and departmental alignment.
• Staff and stakeholders will be engaged throughout the process to ensure smooth transition and adoption.
• Updates will be provided to the Board/Committee as recommendations are finalized and implemented.
2. Salary Survey
Background
At CCHP, we have experienced persistent challenges in recruiting and retaining experienced staff for leadership and key management positions. Subjectively, our salaries have not been competitive and have not allowed us to attract high-caliber candidates or adequately reward current team members for their responsibilities and performance.
During the June 2025 Joint Conference Committee (JCC) meeting, JCC members and CCHP leadership agreed to initiate a salary analysis and market comparison using the most recent available data. This analysis and report represent the outcome of that decision. This decision was informed by internal discussions on recruitment and retention challenges, as well as ongoing efforts to modernize operations and strengthen alignment with industry standards.
This analysis is based on the 2024 Local Health Plans of California (LHPC) Salary and Benefit Survey Report. The Local Health Plans of California (LHPC) is an association that represents all of California’s publicly governed, not-for-profit health plans that serve Medi-Cal enrollees. LHPC conducts regular salary and benefit surveys to support member plans in assessing competitiveness, equity, and workforce planning. Their survey database includes robust compensation data from plans of similar structure and mission and serves as a reliable benchmark for evaluating salaries across leadership and operational roles.
The LHPC survey includes minimum and maximum salary ranges by role type, plan size, and organizational structure, offering a comprehensive and recent snapshot of compensation trends.
As part of CCHP's commitment to workforce competitiveness, fiscal stewardship, and talent retention, we conducted a comparative salary analysis of CCHP leadership and key management positions against industry benchmarks from the Local Health Plans of California (LHPC) compensation database. This review aligns with best practices in organizational development and supports CCHP's broader efforts to modernize its operations, promote internal equity, and remain a competitive employer in California's dynamic healthcare market.
Purpose of the Analysis
The purpose of this analysis is to:
• Assess how current CCHP salaries align with market-based salary data.
• Identify roles where CCHP compensation is potentially under or over the prevailing market rate.
• Support data-driven recommendations to improve recruitment, retention, and organizational stability.
• Inform leadership decisions regarding the restructuring and reclassification of specific positions to meet market expectations.
Methodology
The 2024 LHPC survey provided a standardized benchmark across plans and was used as the primary source for comparison. While both median and mean salary data were available, this analysis uses the median as the primary reference point. The median provides a more accurate and stable benchmark, minimizing the influence of outliers and better reflecting compensation norms across similar publicly governed health plans.
The analysis compared CCHP salary ranges by job title to corresponding ranges in the LHPC salary database. Key data points included:
• CCHP salary range.
• LHPC salary range and median for comparable roles.
• Relative position of CCHP compensation compared to the LHPC median.
Key Observations
• High-End Alignment: Five roles fall above the LHPC median, suggesting strong compensation relative to the market.
• Low-End Concentration: Several roles that are within the LHPC salary range are concentrated below the LHPC median. This indicates that, while technically within the LHPC range, these roles may not be competitive from a recruitment or retention standpoint.
• For several classifications, CCHP may have contributed to the lower end of the LHPC salary benchmark range, particularly where County step structures are used and where peer organizations do not use similar civil service classifications.
This evidence supports the need for CCHP to revise salary structures for roles currently below or on the lower edge of the market range. Doing so would help ensure that positions critical to operational and clinical success can attract and retain the necessary talent, especially as the Plan prepares for growing regulatory oversight and performance expectations.
Conclusion
This analysis confirms that while most CCHP roles are generally aligned with market standards, there is a clear need for action in positions that are below the LHPC median. Addressing below-median compensation will be critical to strengthening CCHP’s recruitment and retention capabilities, especially in high-impact roles tied to quality, compliance, and operations. Making targeted revisions will also improve CCHP’s ability to recruit and retain top talent, ensure organizational equity, and enhance overall operational readiness and regulatory compliance.
Recommendation
CCHP leadership should work with CCH Personnel and County HR to address compensation where necessary to recruit and maintain talent within the plan.
Requested Action of the Board:
Accept this report on the salary analysis and organizational structure analysis. Direct the Interim CEO of CCHP to collaborate with Contra Costa Health - Personnel and County Human Resources on next steps for aligning CCHP salaries with market benchmarks, including making compensation adjustments, as necessary. Direct CCHP leadership to develop an implementation roadmap to strengthen organizational structure in alignment with best practices and operational needs.