About CalOptima

Press Release

CalOptima's Financial Support Addresses Ongoing Pandemic

Programs will increase funding for health networks, incentivize vaccination for members and expand infection prevention training in nursing homes

ORANGE, Calif. (January 8, 2021)

The CalOptima Board of Directors approved $45.6 million in funding and programs in response to the ongoing pandemic and start of vaccination efforts. The increased support will reach health networks, providers and nursing homes, and offer incentives to members who receive the COVID-19 vaccine once it is available to them. Vaccine distribution will follow a federally approved phased approach that prioritizes high-risk groups first, followed by the general public later in the year.

The actions include:

  • Increasing contracted health networks’ Medi-Cal capitation rate by 5% for the period January 1–June 30, 2021, totaling approximately $9 million. Eleven health networks representing thousands of contracted doctors will receive the increase, which is designed to address higher COVID-19-related costs.
  • Launching a Vaccination Incentive Program to offer two $25 nonmonetary gift cards to CalOptima Medi-Cal members who get both required doses of the COVID-19 vaccine, subject to state regulatory approval. CalOptima plans a multipronged member outreach program to promote vaccination and will work with the Orange County Health Care Agency (HCA) on the administration of the incentive program, which is approved to spend up to $35 million.
  • Creating a Vaccination Intervention and Member Incentive Strategy to promote vaccination of members experiencing homelessness. Medi-Cal members who are homeless and age 14 or older will be eligible for two $25 nonmonetary gift cards for receiving both required doses of the COVID-19 vaccine, subject to state regulatory approval. CalOptima will coordinate with community health centers, shelter operators and others to reach homeless members and promote vaccine access in the $400,000 program.
  • Expanding and extending the Orange County Nursing Home COVID-19 Infection Prevention Program, totaling $1.2 million. A partnership with UC Irvine infectious disease experts, the program will support urgent educational webinars to increase vaccine uptake among nursing home staff and extend the infection prevention training that began in May 2020.

“Reaching high COVID-19 vaccination rates across Orange County, especially in the hardest-to-reach ethnic communities, will be key to achieving broader population immunity,” said Supervisor Andrew Do, Chair of the CalOptima Board of Directors and Acting Chairman of the Orange County Board of Supervisors. “CalOptima’s actions signify our commitment to encourage vulnerable populations to get vaccinated and support the providers who have shown incredible dedication to our communities.”

CalOptima has approximately 4,100 members living in more than 60 contracted long-term care facilities throughout Orange County. Nursing home residents and staff are in the high-risk group receiving vaccines first, but the need for infection control in the facilities remains. “The UCI/CalOptima program intensifies educational efforts and infection prevention training for nursing home staff to slow the spread of COVID-19, promote vaccine safety and effectiveness, and begin to reverse the devastatingly high case and death rates,” said Emily Fonda, M.D., CalOptima Interim Chief Medical Officer.

While the nursing home program reaches a targeted population of CalOptima members, the gift card incentive programs are designed to directly motivate large numbers of members to seek vaccination. “As the health care plan for one in four residents in Orange County, CalOptima has a responsibility to encourage members to take action that will fight the pandemic and move our community toward herd immunity,” said Richard Sanchez, CalOptima Chief Executive Officer. CalOptima’s funding will support up to 700,000 Medi-Cal members participating in the incentive program.

About CalOptima

A county organized health system, CalOptima provides publicly funded health care coverage for low-income children, adults, seniors and people with disabilities in Orange County, California. CalOptima’s mission is to provide members with access to quality health care services delivered in a cost-effective and compassionate manner. In total, CalOptima serves more than 800,000 members with a network of 9,000 primary care doctors and specialists as well as 38 acute and rehab hospitals.

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