Publications / 2022 Edition — California’s County-Based Health Plans

2022 Edition — California’s County-Based Health Plans


California’s county-based health plans are public entities organized through one or more counties to provide Medi-Cal enrollees, and in some cases county employees and Covered California enrollees, comprehensive managed care. Most county-based health plans are independent public agencies organized under California law as either local initiatives or County Organized Health Systems. These plans cover one in every five Californians. Learn about these plans: what they are, where they operate, and how their enrollment and finances have changed in recent years.


All County-Based Plans Combined

Enrollment (reported as of the end of June) grew slightly (1.1%) in 2020.

Revenue grew in 2019 and 2020, a turnaround from its decline in 2018.

Margins narrowed in 2018 to 2020, and they were less than half the level of margins in the preceding five years. The overall margin in 2020 was 0.3%. Growth in revenue (5.7%) was offset by rising medical (8.1%) and administrative (6.4%) costs (not shown).

Health Plan Details

Rising medical and administrative expenses had eroded margins for most plans.

In 2020 enrollment increased for 12 plans. Revenues grew in 2020 for 13 of 16 plans. Despite the enrollment and revenue gains for most plans in 2020, the average margin in 2020 (0.3%) remained lower than the 10-year average (2.3%). In 2019 and again in 2020, 6 of the 16 plans lost money, up from 4 in 2018.

Where County-Based Plans Operate

Scroll over a county to find out which plan is available. Counties mapped in gray do not have a county-based plan.

The data file and individual charts are available for download below. These materials are part of CHCF’s California Health Care Almanac, an online clearinghouse for key data and analyses describing the state’s health care landscape. See our entire collection of current and past editions of California Health Insurers and Enrollment.

Notes: Enrollment figures are as of June. Revenue, net income, and margin reflect fiscal year annual results. All growth is annual. Contra Costa Health Plan and Valley Health Plan include both Medi-Cal enrollees and county employees; Ventura County Health Care Plan was established to serve county employees and their dependents. Data were not available for Gold Coast Health Plan, which is Ventura County’s Medi-Cal managed care plan.

Source: “Health Plan Financial Summary Report” (2012–21), California Dept. of Managed Health Care.

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