California payer boosts Medicaid rates by $526M

The board of directors for Orange, Calif.-based CalOptima Health  has approved a $526.2 million investment to increase pay rates for hospitals, providers, community clinics, behavioral health providers, ancillary services providers and health networks.  

The organization provides health insurance benefits for nearly one in every three Orange County residents and plans to use the investment to promote longer-term financial stability for a 30-month period running from July to December 2026 for the managed care network, according to a June 17 news release.

The funding will also help provide timely critical healthcare services access for members of the network.

"Historically, Medi-Cal reimbursement has been a barrier to access for patients and their families," Michael Hunn, CalOptima Health CEO, said in the release. "During the public health emergency, CalOptima Health supported providers with temporary, short-term supplemental payments. These new rate increases will help ensure member access, provider financial stability, network access and medical care for CalOptima Health members throughout Orange County over the next two and a half years."

CalOptima Health's network expands to 10,900 primary care providers and specialists and 39 acute and rehab hospitals, the release said.

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