Forward leading,
looking back.
2022/2023 Community Report
CenCal Health is the Medi-Cal Managed Care health plan
in Santa Barbara & San Luis Obispo counties.
Message from the CEO
At CenCal Health, we value compassionate service, collaboration, integrity and improvement. I am pleased to present our 2022-2023 Community Report, which provides an opportunity to reflect back on achievements and share opportunities for the future. Through this report, we bring our values to life.
Our vision is to be a trusted leader advancing health equity so that our communities thrive and achieve optimal health together. We care about the word “together” and our priority is to cultivate community partnerships. California is pursuing an ambitious, multi-year plan to transform the Medi-Cal Program through California’s Advancing and Innovating Medi-Cal (CalAIM). Through this effort, CenCal Health is developing new programs and benefits to expand our role and reach.
This year, CenCal Health celebrates its 40th anniversary in Santa Barbara County and 15th in San Luis Obispo County. We appreciate our Board of Directors, providers, community partners and employees who demonstrate that a local health plan can be accountable to the community it serves and achieve the promise of our mission. We are leaving a legacy of wellness for future generations and our mission is to improve the health and well-being of the members we serve right here on the Central Coast. I invite you to continue the journey. Through our partnership, the future is bright.
Marina Owen, Chief Executive Officer
The mission of CenCal Health
To improve the health and well-being of the communities we serve by providing access to high-quality health services, along with education and outreach, for our members.
AND
The vision of CenCal Health
To be a trusted leader in advancing health equity so that our communities thrive and achieve optimal health together.
The values
we stand for…
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Serving and advocating for all customers with excellence.
• Serving and advocating with kindness, compassion, empathy, and respect
• Understanding the unique needs of our members, providers, community partners, and one another to provide excellent service -
Coming together to achieve exceptional results.
• Valuing the interconnectedness of the diverse communities we are a part of and serve
• Empowering thoughtful, open, inclusive, and data-based information
• Ensuring open, honest communication that recognizes everyone’s unique contributions -
Doing the right thing, even and especially when it is hard.
• Diligently making, executing, and standing behind shared decisions
• Committing to and accomplishing collective goals -
Continually improving to ensure our growth, success, and sustainability.
• Continually examining our organization for creative and innovative solutions
• Prioritizing, coordinating, and executing in pursuit of excellence
Our
Membership
231,154
Membership growth in 2022:
16,449
Members covered through the
Affordable Care Act in 2022:
71,207
As of February 2023
About
CenCal Health
CenCal Health is the community-based health plan that administers Medi-Cal benefits in Santa Barbara and San Luis Obispo counties. We partner with a vast network of doctors, hospitals, and other types of providers to deliver health care services to Medi-Cal members on the Central Coast — about one in four residents of Santa Barbara County and one in five residents of San Luis Obispo County.
Forward leading
Our Strategic Plan goals
Strategic planning presents an important opportunity to listen to our partners and employees. An extensive planning process incorporated insights from community partners, key stakeholders, and CenCal Health staff regarding our direction and priorities.
Our Strategic Plan allows us to reflect on our changed environment and its implications for the future so that CenCal Health can develop a thoughtful path forward that best serves our members and community.
#1
Cultivate community partnerships
#2
Advance quality &
health equity for all
#3
Expand our service role & reach
#4
Organize for impact & effectiveness
The path forward
CalAIM
What is CalAIM?
California Advancing and Innovating Medi-Cal, also know as “CalAIM,” is the State of California’s ambitious long-term commitment to transform and strengthen Medi-Cal.
Our Strategic Plan goals support the local implementation of CalAIM in our communities.
Objective 01
Facilitate community collaboration to strengthen the health system
STRATEGIES
Convene, educate and collaborate with community stakeholders on Medi-Cal reforms, changes and directions to enable coordinated action
Align the CenCal Health Doorway to Health Foundation to advance quality and health equity for all and promote innovation
Play a leading policy role as liaison, educator and advocate for local Medi-Cal and safety-net health care priorities at the local and statewide level
Objective 02
Engage locally on health equity
STRATEGIES
Embrace the role of convener, facilitator, and humble partner with other health providers, social service leaders and government agencies to promote health equity
Solicit member, provider and community partner voices through meaningful engagement to improve customer experience
Collect, analyze and share data on health disparities and the social determinants of health to propel community action
#1
Cultivate community partnerships:
What that looks like.
Quality program supports physician excellence in healthcare
To maximize quality medical care for our members, in March 2022, CenCal Health launched the value-based Quality Care Incentive Program (QCIP). QCIP offers incentives to primary care providers who deliver exceptional medical care.
The program emphasizes clinical priorities of significance to CenCal Health members, such as diabetes and asthma care, breast cancer and cervical cancer screenings, and child and adolescent well-care visits.
Payments are also tied to the diversity of member patients managed by each physician; as such, incentives increase to reflect the proportion of members of greater clinical complexity, for example, the aged or those disabled. As of January 2023, QCIP has resulted in a distribution of over $7 million in payments.
CenCal Health & community partners implement transformative Medi-Cal initiative
CalAIM is a groundbreaking, multi-year initiative developed by the California Department of Health Care Services. CalAIM goes beyond traditional medical care and provides expanded services to Medi-Cal members that address social factors affecting people’s health, including homelessness, behavioral health, care of older adults, services for individuals transitioning from incarceration, and beyond. In Santa Barbara and San Luis Obispo counties, CenCal Health is responsible for implementing CalAIM with its community partners.
In 2022, CenCal Health launched two initiatives under the CalAIM framework: Enhanced Care Management – a comprehensive case management benefit; and Community Supports, which provides medically appropriate, cost-effective alternatives to traditional medical services or settings.
Our network excellence is proven
The Healthcare Effectiveness Data and Information Set (HEDIS®) is a set of standardized performance measures designed to ensure that purchasers and consumers have the information they need to reliably compare health care quality. Based on the 2022 HEDIS report, CenCal Health is:
#1 in preventive health care utilization rates for children, out of 56 contracted Medi-Cal Managed Care entities. Santa Barbara County
#2 in Well Child Visits for children & adolescents ages 3-21, out of 56 contracted Medi-Cal Managed Care entities.
San Luis Obispo County
Top 5% for Timely Postpartum Care among Medicaid plans nationwide.
Santa Barbara
& San Luis Obispo
counties
#2
Advance quality & health equity for all:
What that looks like.
Objective 02
Reduce health disparities in our populations
STRATEGIES
Develop a health equity strategy
Implement population health capabilities to identify and address health disparities among our Medi-Cal members
Enhance insight into health disparities by expanding the collection and sharing of drivers of health indicators
Objective 01
Exceed quality standards & expectations
STRATEGIES
Expand quality strategies to be a top quality performer among Medi-Cal health plans
Enhance the Quality and Equity Program by achieving NCQA accreditation
Partner with our provider network to support targeted quality improvements
Providers offered funding to address social determinants of health
CenCal Health’s Incentive Payment Program makes funds available for community partners to build and increase capacity for two CalAIM initiatives: Enhanced Care Management and Community Supports. Implemented in 2022 by the California Department of Health Care Services, the Incentive Payment Program ensures that CenCal Health and its CalAIM partners are poised to provide Medi-Cal members the tools and support needed to achieve optimal health outcomes.
Funding may be used by Enhanced Care Management and Community Supports providers, including community-based organizations, county organizations, and traditional healthcare providers, toward activities including staffing support; infrastructure or capital investment; data/information technology development; staff training, and operations.
Industry audits substantiate high quality pediatric care provided by local physicians
Two respected professional health care assessments recognized CenCal Health with high marks in 2022. The National Healthcare Effectiveness Data and Information Set (HEDIS®) and the state-wide report on Consumer Assessment of Healthcare Providers and Systems (CAHPS®) uphold the high-quality pediatric care provided by Medi-Cal physicians on the Central Coast. According to the results, for the second year in a row, both counties covered by CenCal Health received the highest HEDIS rating – top 5% in the nation – for timeliness of women’s postpartum care. Similarly, the CAHPS report rated CenCal Health No. 1 in Customer Service for Child Members.
Our members rank their experiences
The Consumer Assessment of Healthcare Providers and Systems (CAHPS®) is a standardized survey instrument to assess the patient experience of members.
Based on the 2022 CAHPS report, CenCal Health is:
# 1 in customer service
for child members, out of
25 health plans in
California.
# 2 in overall rating
of health plan for child members, out of 25 health plans in California.
#3 in overall rating
of personal doctor for child members, out of 25 health plans in California.
#3
Expand our service role & reach:
What that looks like.
Objective 01
Prepare to serve new members
STRATEGIES
Prepare for a sustainable and integrated Medi-Cal and Medicare program serving dually-eligible members
Explore local needs and market opportunities for Covered California and Medicare Advantage
Facilitate Medi-Cal coverage expansions for newly eligible residents
Objective 02
Develop new Medi-Cal programs & benefits
STRATEGIES
Expand Enhanced Care Management, Community Supports and Community Health Workers programs responsive to local needs
Invest in capacity to serve members through State-sponsored incentive programs
Advocate to preserve and support local voice and decision-making
Medi-Cal expansion of healthcare coverage for older adults now in effect
In May 2022, as part of a statewide initiative, CenCal Health expanded its coverage to undocumented residents ages 50 and above, providing low-income Central Coast community members the ability to receive Medi-Cal, regardless of their documentation status. Qualifying applicants who meet eligibility rules receive full-scope Medi-Cal health benefits.
New benefit provides comprehensive care management to members
Enhanced Care Management is a new CalAIM benefit for members with complex needs, requiring seamless coordination between multiple doctors and other care providers to address clinical and non-clinical matters. Enrolled members are assigned a lead care manager who helps the member navigate and access various services and appointments. The benefit focuses on breaking down the traditional walls of health care – extending beyond hospitals and health care settings into communities.
Community Supports: Linking health & social support services
Community Supports are optional services developed under CalAIM. Health plans like CenCal Health may offer Community Supports with approval from the California Department of Health Care Services.
These support services address members' health-related social needs and are medically appropriate, effective alternatives to traditional medical services or settings. The goal is to provide individuals whose wellness is impacted by complex social factors — including homelessness, behavioral health, care needs for older adults, and more — a greater opportunity to enjoy healthier lives in a safer environment.
As of January 1, 2023, CenCal Health offers six Community Supports services. Click the link below to learn more about the Community Supports services available to CenCal Health members.
Kind words
"This is personal for me, it really is, because I was a Medi-Cal recipient as a child. CenCal Health does excellent work and I applaud the staff of
CenCal Health. You are amazing."
- Dr. René Bravo, CenCal Health Board Chair
“He was absolutely phenomenal in helping me in my time of need. Cris just went in and basically saved my day... I am eternally grateful and thankful, and I am just so blessed to be a CenCal member. Thank you so much.”
“CenCal never fails to impress me. Just so swift, and efficient, and helpful, and knowledgeable – really knowledgeable, and able to read all the records, and make executive decisions on the fly. I am very, very grateful…”
"I am very happy with the service that you gave me today, and the past times that I have had to call. Thank you very much, and may God continue to bless you and give you the patience to help us."
Spanish testimonial
Objective 01
Advance organizational readiness to support strategy
STRATEGIES
Develop planning and execution capabilities to advance organizational integration and coordination
Achieve insight into organizational performance to target improvements
Adapt processes through continuous improvement methodologies
#4
Organize for impact & effectiveness:
What that looks like.
Objective 02
Foster employee growth & inclusion towards a diverse culture
STRATEGIES
Develop a strategic human resources function and capabilities to meet future state requirements
Evolve core competency requirements and performance management system
Enhance employee training and development
Objective 03
Leverage and adapt technology & analytics to enable transformation
STRATEGIES
Evolve technology model to emphasize external partnerships, to meet business needs
Develop advanced analytical insight to support the management and improvement of member care
Advance health data exchange and interoperability solutions
Objective 04
Ensure financial performance to support sustainability
STRATEGIES
Develop strategic financial function to evaluate regional rates impact and interventions
Evolve cost containment focus to manage member risk and needs
Deploy targeted investment and incentive strategies
Organizing for impact: Key new positions added
To be a trusted leader in advancing health equity, meet the promise of our mission and seize the opportunity of the ambitious, multi-year plan to transform the Medi-Cal Program, CenCal Health has been organizing within the health plan for impact and effectiveness.
Employee-led advisory committee guides diverse culture
As part of organizing for impact and effectiveness, fostering employee growth and inclusion towards a diverse culture was top of mind to CEO Marina Owen, who launched CenCal Health’s first CEO Advisory Committee.
New member portal leverages technology to deliver self-service
More people are relying on digital tools to fulfill their health needs. Looking to enhance member experience and improve accessibility to personalized health plan information, CenCal Health developed a new portal specifically for individual member accounts. This self-service platform allows beneficiaries to view and manage their Medi-Cal benefits from anywhere, anytime.
New financial forecasting model
To ensure our financial performance supports sustainability, CenCal Health is developing a robust analytical model that will provide a five-year financial forecast on revenue and expenditures. The calculations are based on CenCal Health’s annual operating plan, funding from the California Department of Health Care Services, and current economic trends.
Award-winning collaborations
CenCal Health and our provider partners have developed numerous initiatives that seek to educate, advocate, and better serve our members and communities. The following are two award-winning collaborations we would like to highlight.
CenCal Health Board of Directors
CenCal Health is governed by a 13-member Board of Directors, appointed by the Santa Barbara and San Luis Obispo Counties’ Boards of Supervisors. The CenCal Health Board includes representatives from local government and county representatives, which have no term limits. Other positions include physicians, hospital administrators, and representatives from the business community and membership, many of whom have served our organization for many years. In 2022, Lynda Tanner, past President and CEO of VNA Health, chaired the Board meetings. In 2023, pediatric specialist Dr. René Bravo chaired the Board meetings.
Meet our Board of Directors
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Dr. René Bravo
Bravo Pediatrics,
Chair of the BoardProvider Representative
San Luis Obispo County
2022/2023
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Mark Lisa
CEO of Tenet Health Central Coast,
Vice ChairProvider Representative
San Luis Obispo County
2022/2023
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Sue Andersen
President & CEO of
Marian Regional Medical CenterProvider Representative
Santa Barbara County
2022/2023
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Dr. Edward Bentley
Santa Barbara
Gastroenterology ConsultantsProvider Representative
Santa Barbara County
2022/2023
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Joan Hartmann
Board of Supervisors
District 3County Supervisor
Santa Barbara County
2022/2023
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Dan Herlinger
Consumer
RepresentativeCommunity Business
Santa Barbara County
2022/2023
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Sara Macdonald
Consumer
RepresentativeMedi-Cal Recipient
Santa Barbara County
2023
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Kieran Shah
President & CEO of
VNA HealthProvider Representative
Santa Barbara County
2023
-
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Dawn Ortiz-Legg
Board of Supervisors
District 3County Supervisor
San Luis Obispo County
2023
-
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Nick Drews
Director of
Health AgencyCounty Representative
San Luis Obispo County
2023
-
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Antonette "Toni" Navarro
Director of
Behavioral WellnessCounty Representative
Santa Barbara County
2023
-
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Mouhanad Hammami
Director of
Public HealthCounty Representative
Santa Barbara County
2023
-
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Debbie Arnold
Board of Supervisors
District 5County Supervisor
San Luis Obispo County
Former BOD member - 2022
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Daniel Nielson
Director of
Department of Social ServicesCounty Representative
Santa Barbara County
Former BOD member - 2022
-
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Lynda Tanner
Past President & CEO of
VNA HealthProvider Representative
Santa Barbara County
Former BOD member - 2022
We want to hear how CenCal Health
has impacted you.
Meet our Executive Leadership
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Marina Owen
Chief Executive Officer
-
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Chris Morris
Chief Performance Officer
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Van Do-Reynoso, PhD
Chief Customer Experience Officer
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Bill Cioffi
Chief Information Officer
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Dr. Emily Fonda
Chief Medical Officer
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David Ambrose
Chief Financial Officer (2007 - Feb 2023)
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Kashina Bishop
Chief Financial Officer (Began Feb 2023)
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Karen Kim
Chief Legal and Compliance Officer
As a public agency, CenCal Health contributes approximately $50 million a month into the local economy, primarily through payments to healthcare providers who serve our membership.
Our Financials
Celebrating 40 years
in Santa Barbara County
In 1983, a local pilot program for managed care gave birth to a health insurance plan recognized by The Ford Foundation and Harvard University for its innovation and efficiency.
That plan – originally called the Santa Barbara Health Initiative – became known as CenCal Health, the nation’s first locally-administered Medicaid program of its kind. The original nine employees of the Santa Barbara Health Initiative, under the leadership of Santa Barbara County's Health Care Services Director Dr. Lawrence Hart, brought local oversight to the Medi-Cal delivery system.
View the entire Strategic Plan
CenCal Health is committed to advancing the priorities and objectives outlined in our 2023-2025 Strategic Plan. These priorities serve as the key frameworks going forward and will be influenced by environmental factors that may impact our working strategies and timeline. Through meaningful dialogue and continued collaboration, we will engage with our community partners, providers, and stakeholders in the next steps.