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CalOptima Health Adds Providence as 10th Contracted Health Network

게시됨:2025년 10월 29일

New agreement will improve care coordination and case management for Orange County Medi-Cal members

ORANGE, Calif. (October 29, 2025) — CalOptima Health will add its 10th health network by partnering with Providence, marking a significant step in strengthening access to health care services for Medi-Cal members in Orange County. Effective November 1, the partnership will provide enhanced care coordination and comprehensive health and wellness services for thousands of Medi-Cal members.

CalOptima Health’s Board of Directors approved the Shared Risk Group (SRG) agreement with Providence during its September 4, 2025, meeting. Under this arrangement, Providence will be responsible for physician services, including medical authorizations, claims, diagnostic and prevention services, while CalOptima Health will be responsible for hospital-related services, behavioral health and transplants.

Providence providers currently serve 13,000 CalOptima Health Medi-Cal members in a fee-for-service model. Under the new SRG agreement, these members will be overseen directly by Providence’s network, which will mean more seamless coordination and case management. Members whose primary care provider is a Providence practitioner will continue to see that provider with no change.

“Providence has a long history of providing for the underserved populations of Orange County,” said Michael Gomez, CalOptima Health’s Executive Director of Network Operations. “Their mission is our mission: to serve this vulnerable population with dignity, respect and the highest level of care.”

Providence’s history in Orange County goes back to 1922, when the Sisters of St. Joseph took over 20 acres of land in Orange to build a hospital as part of the order’s mission to provide education and medical care. Today, Providence’s network includes more than 2,000 Orange County doctors and specialists and hospitals in Laguna Beach, Mission Viejo, Orange and Fullerton.

“We are excited about our new partnership with CalOptima Health as a delegated health network,” said Jill Duplechan, Chief Executive of Providence Clinical Network – South. “This new model will enable us to enhance care coordination for CalOptima Health members, ensuring they receive clinically excellent, compassionate care from Providence physicians, providers and caregivers. With our expansive network of hospitals, clinics and urgent care centers strategically located throughout Orange County, we are well-positioned to serve our communities and valued patients.”

About CalOptima Health

A county organized health system, CalOptima Health provides quality health care coverage for low-income children, adults, seniors and people with disabilities in Orange County, California. CalOptima Health’s mission is to serve member health with excellence and dignity, respecting the value and needs of each person. CalOptima Health serves more than 890,000 members with a network of 8,900 primary care doctors and specialists and 43 acute and rehab hospitals. Visit www.caloptima.org.

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