To: Board of Supervisors
From: Dr. Grant Colfax, Health Services Director
Report Title: Contract Amendment #23-773-7 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 #23-773-7 with Health Management Associates, Inc., a corporation, effective January 1, 2026, to amend Contract #23-773-2 (as amended by Contract Amendments #23-773-3 through #23-773-6), to provide additional actuarial consulting services to CCHP and modify the contract provisions to include Department of Managed Health Care (DMHC) required language concerning Dual Eligible Special Needs Plan (D-SNP) obligations and requirements, with no change in the payment limit of $3,820,000 or term ending September 30, 2026.
FISCAL IMPACT:
Approval of this Contract Amendment will not impact the payment limit of $3,820,000 and is funded 100% by Contra Costa Health Plan Enterprise Fund II revenues. (No rate increase)
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 Contract Amendment #23-773-3 to increase the payment limit by $300,000 to a new payment limit of $600,00, for additional actuarial consulting services with no change in the term.
On September 10, 2024, the Board of Supervisors approved Contract Amendment/Extension #23-773-4 to increase the payment limit by $250,000 to a new payment limit of $850,000, for additional actuarial consulting services and extend the term from September 30, 2024 to September 30, 2025.
On December 3, 2024, the Board of Supervisors approved Contract Amendment #23-773-5 to increase the payment limit by $1,200,000 to a new payment limit of $2,050,000, for additional actuarial consulting services with no change in the term.
On September 9, 2025, the Board of Supervisors approved Contract Amendment/Extension #23-773-6 to increase the payment limit by $1,770,000 to a new payment limit of $3,820,000, for additional actuarial consulting services and extend the term from September 30, 2025 to September 30, 2026.
Approval of Contract Amendment #23-773-7 will allow the Contractor to provide additional actuarial consulting services to CCHP and will allow CCHP to modify the contract’s service plan provisions to conform with DMHC requirements by including DMHC required language concerning D-SNP requirements and obligations, with no change in the payment limit of $3,820,000 or term ending September 30, 2026.
CONSEQUENCE OF NEGATIVE ACTION:
If this Contract Amendment is not approved, the Office of the Director/Finance will not be compliant with Center for Medicare and Medicaid Services (CMS) Network Adequacy regulatory requirements.