About CalOptima

Better For Our Community

Working together to improve local health care

A look back

In the early 1990s, the Medicaid system, known as Medi-Cal in California, was struggling to meet the needs of Orange County’s residents and providers. Many Medi-Cal members found it difficult to find primary care providers, and too often they were forced to seek primary care in emergency rooms. Sometimes they waited for hours, only to see doctors with whom they had no prior relationship. And sometimes they gave up or were turned away and didn’t get the care they needed. It became such as severe problem that a concerned group of community members, health care providers, business leaders and elected officials got together to find a solution. That solution was CalOptima.

The solution

CalOptima was created by the Orange County Board of Supervisors in 1993 as a County Organized Health System (COHS). We are a public agency and the largest of six COHS in California. CalOptima manages programs that are funded by the state and federal government, but operates independently, under the leadership of a Board of Directors made up of members, providers, business leaders and local government representatives.

CalOptima today

Today, CalOptima is the single largest health insurer in Orange County, providing coverage for one in four residents through four programs, Medi-Cal, OneCare Connect, OneCare and PACE. We are proud of who we are and what we’ve become. We were created by the community to fill a critical need, and now we are a model community health plan recognized for delivering access to quality care. CalOptima is also a prudent steward of public funds. About 96 cents of every dollar we receive goes directly to medical care. Our administrative costs are among the lowest in California, compared with other public and commercial health plans. At CalOptima, we take our mission to serve members seriously and strive daily to exceed their expectations.

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