CalOptima Signs Agreement with Altruista Health to Implement Integrated Medical Management Platform

Altruista’s GuidingCare™ System Will Help Streamline and Optimize Daily Care Management Activities Between CalOptima Staff, Care Providers, Community Supports and Health Plan Members
CalOptima Signs Agreement with Altruista Health
CalOptima Signs Agreement with Altruista Health
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Care Management


Orange - California - US


ORANGE, Calif. - June 26, 2014 - PRLog -- Altruista Health, Inc., an innovative provider of care management technology solutions for health plans and care provider organizations, has been selected by CalOptima ( to implement Altruista’s GuidingCare™ care management solution. CalOptima is the second-largest health insurance provider in Orange County, California, and offers numerous programs for low-income families, children, seniors and persons with disabilities, including Medi-Cal (California Medicaid), OneCare (a special-needs program for citizens eligible for both Medicare and Medicaid) and PACE (Program for All-Include Care of the Elderly).

Altruista Health developed GuidingCare to address the complex care and support needs of Medicaid enrollees and other highly vulnerable and medically fragile populations. Health plans in more than a dozen states, including California, New York, Colorado and Hawaii, currently use GuidingCare to manage enrollees in a variety of federal and state-wide managed care initiatives, including Medicaid/Medicare Dual Eligible (, Managed Long-term Care (MLTC), Long-term Supports and Services (LTSS) and other special-needs programs.

As an integrated suite of population health management, predictive data analytics and clinical decision support tools, GuidingCare enables health plan staff and affiliated resources to provide patients with clinically appropriate care management, health education and support services in a timely, efficient and cost-effective manner. GuidingCare’s flexible, service-oriented architecture allows health plans to tailor almost every aspect of the platform to meet specific demographic, geographic and cultural characteristics and align with ever-changing regulatory requirements.

“Altruista Health’s clinically-based technology platform and Medicaid expertise in several states, including California, were important factors in our decision,” said Richard Helmer, Chief Medical Officer for CalOptima. “Regulatory demands at both the state and federal levels require technology solutions that can adapt quickly to meet new workflow and reporting needs. During our selection process, Altruista Health and GuidingCare demonstrated capabilities that we anticipate will translate these systems into tangible value for our members.”

CalOptima has consistently been ranked as one of California’s highest-quality health plans. Earlier this year, CalOptima ranked fourth out of 46 California plans for Medi-Cal quality and fourth/fifth in adult/child member satisfaction (respectively) based on the California Department of Health Care Services (DHCS) Medi-Cal Managed Care Performance Dashboard. CalOptima also enjoys a very low administrative rate, with more than 95 cents of every dollar going toward member care.

CalOptima is a member of many associations, including the Association for Community Affiliated Plans (ACAP). Altruista Health has been an ACAP Preferred Vendor for two years. The Preferred Vendor status is granted by ACAP to organizations that dlwtq are endorsed by at least one ACAP plan, and with no members saying they would not recommend the vendor. CalOptima joins several other ACAP member plans as Altruista Health clients, including Affinity Health, (NY), AlohaCare (HI), Colorado Access (CO), Denver Health (CO), Elderplan (NY) and Visiting Nurse Services of New York (NY).

“CalOptima is an essential resource for nearly 600,000 Orange County residents and provides efficient, cost-effective access to quality care,” said Ashish Kachru, CEO of Altruista Health. “We are honored to partner with an organization as dedicated to member value as CalOptima, and we are excited to work together to help them improve their operational efficiency and dedication to member wellness even further.”

About CalOptima

A California County Organized Health System, CalOptima provides publicly funded health care coverage for low-income children, adults, seniors and persons with disabilities in Orange County, CA. 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 nearly 600,000 members with a network of more than 7,800 primary care doctors and specialists, as well as 37 hospitals. “Better. Together.” is CalOptima’s motto, but it’s also the philosophy. By working together, we can make things better – for the members and community. Learn more at

About Altruista Health

Headquartered in the Washington D.C. area, Altruista Health is an innovative provider of care management technology solutions that address the complex care and support needs of Medicaid, long-term care and other special needs populations. The company has rapidly become an industry leader; the Gartner Group has identified Altruista Health as one of the fastest growing care management technology companies in the government sector. More than 25 organizations operating across a dozen states use our solutions each day to streamline clinical and administrative processes, improve patient outcomes and reduce avoidable healthcare costs. For more information, visit

Dave Clossey
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Tags:Care Management, Medicaid, Medical, Caloptima
Industry:Government, Health
Location:Orange - California - United States
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