Council Connect Articles

Two East Bay Counties Pursue County Organized Health System Model for Medi-Cal

Section Update


• Alameda County Board of Supervisors
• Alameda Alliance for Health
• Contra Costa County Board of Supervisors
• Contra Costa Health Plan


As part of the California Advancing and Innovating Medi-Cal initiative to revamp the Medi-Cal program, counties have been given the opportunity to change their Medi-Cal managed care delivery system model. Alameda and Contra Costa counties hope to change from a two-plan model, which provides Medi-Cal beneficiaries the choice of enrolling in either the local Medi-Cal Managed Care Health Plan or a commercial plan (for these counties it is Anthem Blue Cross), to a County Organized Health System model in which all Medi-Cal beneficiaries would be enrolled in the local plan starting in 2024. This month, the Contra Costa County Board of Supervisors passed a local ordinance to make the Contra Costa Health Plan its single plan. The Alameda County Board of Supervisors will take up a similar ordinance for the Alameda Alliance for Health by Oct. 10.

Takeaway/Next Steps

Additional approvals are needed from the Department of Health Care Services and Centers for Medicare & Medicaid Services before this change takes effect as part of the state’s Medicaid waiver. Ultimately, both counties will need federal legislation passed in order to have their local health plans permanently designated as County Organized Health Systems.