Advisory Board: Contra Costa Health Plan Joint Conference Committee
Subject: CCHP IT Report
To: Joint Conference Committee (JCC) Members
From: Bhumil Shah, CIO, CCHP IT (Information Technology)
Date: December 19, 2025
Subject: IT Report
Purpose
To provide the Joint Conference Committee with a high-level overview of activities within the IT Department, progress, priorities, and challenges.
Department Description
IT Department supports all CCHP's technology needs - from infrastructure and software systems to analytics, artificial intelligence, information security, and technology procurement.
Key Accomplishments and Highlights
* We successfully went live on Oct 15, 2025, with enrollment and call center systems for DSNP. Testing for the remaining systems needed for the DSNP program that go-live on Jan 1 is in progress with over 1500 scenarios being tested.
* We published dashboards to track claims interest payment, and to reconcile revenue and expenses. The dashboard helped identify the key drivers for claims interest payments and remediation steps have been taken by the Finance and Claims teams.
* We developed data exchange with WellSky so that CCHP can get near real time access to Skilled Nursing Facility (SNF) admits/discharges. The go-live is scheduled for early next year.
Current Priorities and In-Progress Work
* CMS-0057-F final rule?requires specific healthcare payers-including Medicare Advantage organizations, state Medicaid and CHIP programs (FFS and managed care), and Qualified Health Plan (QHP) issuers on the Federally Facilitated Exchanges (FFEs)-to?implement technical and operational changes to streamline prior authorization and improve data exchange. The changes need to be implemented by Jan 1, 2027. We have initiated this project to meet CMS regulatory requirements.
* We are actively testing the new system build for the DSNP program to ensure smooth implementation of the program on Jan 1, 2025. As this is new program, we...
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