To: Board of Supervisors
From: Dr. Grant Colfax, Health Services Director
Report Title: Contra Costa Health Plan Quality Improvement and Health Equity Committee Activities Report (July - September 2025)
☒Recommendation of the County Administrator ☒ Recommendation of Board Committee
RECOMMENDATIONS:
ACCEPT the Contra Costa Health Plan (CCHP) Quality Improvement and Health Equity Committee (QIHEC) Quarterly Activities Report for Quarter 3 of 2025, as required under the Department of Health Care Services (DHCS) contract and as recommended by the CCHP Joint Conference Committee (JCC).
FISCAL IMPACT:
There is no fiscal impact for this action.
BACKGROUND:
As part of its Medi-Cal contract with DHCS, CCHP is required to implement and maintain a Quality Improvement and Health Equity Committee (QIHEC). The QIHEC is led jointly by CCHP's Medical Director (or designee) and CCHP's Chief Health Equity Officer and must include participation from a broad range of network providers. The QIHEC is responsible for directing and overseeing all Quality Improvement and Health Equity program activities.
CCHP fulfills this requirement through the work of two standing councils: the Quality Council and the Equity Council. These two bodies together comprise the QIHEC, bringing both clinical and community perspectives to guide the integration of quality and equity efforts across the health plan. The councils oversee performance improvement projects, review member experience and clinical quality data, and recommend corrective actions as needed.
On a quarterly basis, CCHP is required to submit a written summary of QIHEC activities to its Governing Board, DHCS, and make these reports publicly available on its website.
SUMMARY:
During Q3-2025, CCHP advanced significant work across the National Committee for Quality Assurance (NCQA) accreditation, compliance audits, quality measurement, and regulatory reporting. CCHP received final approval for NCQA Health Equity Accreditation in October, following submission of the survey in August. Preparations for the NCQA Health Plan Accreditation survey also remained on schedule, with all documentation collected and undergoing consultant review ahead of the December 9 submission. CCHP additionally completed the DHCS annual Medical Onsite Audit and the Network Adequacy Validation Audit in August; both audits identified limited corrective actions, and the plan has begun implementing necessary process improvements.
Quality measurement and reporting activities were extensive throughout the quarter. CCHP received a 4.5-Star rating from NCQA, the highest rating of any Medicaid plan nationally and one of only 14 Medicaid plans in the country to achieve this score. CCHP also met the Minimum Performance Level for all MCAS measures in MY2024. The plan submitted the MY2024 Health Equity and Quality Measure Set (HEQMS) to the Department of Managed Health Care (DMHC) and began preparing responses for the Corrective Action Plan related to the MY2023 HEQMS. Additional analytic work included preparing and fielding the Provider Appointment Availability Survey, continuing the Case Management and Behavioral Health survey fielding, and concluding data collection for the Experience of Care and Health Outcomes (ECHO) survey. To strengthen provider access to actionable information, CCHP also launched new provider-facing reports in the Provider Portal, including recent hospitalization alerts, behavioral health Emergency Department (ED) visit notifications, and Medi-Cal redetermination data.
CCHP continued to advance Performance Improvement Projects with measurable results. Outreach efforts to members due for well-care visits, cervical cancer screening, and lead screening for young children contributed to improved completion rates and strengthened preventive care engagement across key populations. Targeted efforts continued for African American and Pacific Islander members assigned to Contra Costa Regional Medical Center (CCRMC), and CCHP partnered with Black Infant Health to conduct focus groups addressing barriers to pediatric well-child visits.
Behavioral health work intensified through the second round of the Medi-Cal Behavioral Health Collaborative, including biweekly case reviews with Contra Costa Behavioral Health and Kaiser Permanente to address missed follow-up opportunities. In partnership with Contra Costa County Behavioral Health, Public Health, and Contra Costa Regional Medical Center, CCHP received Top Honors from the California Association of local Health System and Safety Net Institute for this performance improvement project.
Population health activities further expanded CCHP’s equity and prevention efforts. The annual Population Needs Assessment and Population Health Management Strategy were completed and approved by the Quality Council. CCHP participated in the countywide Community Health Assessment Steering Committee, including a full-day planning retreat. CCHP also prepared for the January launch of Transitional Rent as a Community Support, supported CalAIM Center expansion through regular office hours with multiple community-based organizations, advanced ED utilization reduction work, and initiated ingestion of Medi-Cal Connect data to integrate statewide risk stratification into population health workflows.
In Quarter 3, CCHP staff attended more than 20 outreach and health education events and disseminated multiple member newsletters, including Health Sense, as well as maternal health, mental health, and children and family e-newsletters.
CCHP collaborated with Supervisor Diane Burgis, Kaiser Permanente, and Contra Costa County Fire on health literacy initiatives designed to reduce emergency department use, with program launch scheduled for Quarter 4.
Patient safety and provider engagement efforts remained strong throughout the quarter. CCHP continued monitoring and investigating Potential Quality Issues, safety events, and Provider Preventable Conditions while completing Facility Site Reviews and Medical Record Reviews.
Provider engagement activities included distribution of provider-specific Healthcare Effectiveness Data and Information Set (HEDIS) rate sheets, updated health education materials, quarterly network training, and six quality-focused meetings with major provider groups. CCHP also collaborated closely with Contra Costa Regional Medical Center on ambulatory redesign initiatives, including support for a nurse-led asthma clinic and pre-visit screening recommendations. The plan also co-hosted a major doula workshop with Public Health and Families and Individuals Equitably Rootes in Collective Empowerment (FIERCE) Advocates to improve contracting, credentialing, and claims navigation for local doulas.
CONSEQUENCE OF NEGATIVE ACTION:
Failure to accept the QIHEC Quarterly Report would prevent CCHP from meeting its contractual obligation with DHCS and impact CCHP’s compliance standing.