California Health & Wellness

What California Health & Wellness does

California Health & Wellness was a Sacramento-based Medi-Cal managed care health plan that administered comprehensive Medicaid benefits to eligible residents across 19 California counties, including Alpine, Amador, Butte, Calaveras, Colusa, El Dorado, Glenn, Imperial, Inyo, Mariposa, Mono, Nevada, Placer, Plumas, Sierra, Sutter, Tehama, Tuolumne, and Yuba. The plan was a wholly-owned subsidiary of Centene Corporation (NYSE: CNC), operating as part of Centene's multi-state Medicaid managed care portfolio. Services were rendered through a contracted provider network including primary care physicians, specialists, hospitals, and ancillary facilities, with members acquired through California Department of Health Care Services (DHCS) eligibility determination and county assignment rather than consumer-facing marketing.

The company's technology stack supported member enrollment, benefits administration, claims processing, and provider network management. Notable integrations included FHIR-based Patient Access and Provider Directory APIs (CMS-9115-F compliant) accessible via Centene's Partner Portal, the CalAIM Incentive Payment Program Platform supporting Enhanced Care Management (ECM) and Community Supports, the MemberConnections care coordination system connecting members to social services, the PaySpan Health EFT/ERA platform for paperless provider payments, and a secure provider portal for eligibility verification and prior authorizations. The product portfolio extended beyond core medical services to include 14 CalAIM Community Supports offerings, a Community Health Worker program, disease management modules (via Envolve PeopleCare), prenatal support through Start Smart for Your Baby, non-emergency medical transportation via LogistiCare, and vision benefits through Envolve Vision Care.

Revenue was generated through capitated per-member-per-month (PMPM) premiums paid by California DHCS, with eligible members paying no premiums or cost-sharing. The plan's go-to-market was sales-led via state enrollment pathways—county health departments and the California DHCS enrollment system—rather than direct consumer acquisition. Effective January 1, 2024, California Health & Wellness ceased Medi-Cal operations entirely, with members transitioned to other health plans based on county of residence, eliminating the subsidiary's sole revenue-generating activity and triggering administrative wind-down.

Name

California Health & Wellness

Legal name

California Health & Wellness Plan

Website

https://cahealthwellness.com

Company type

Private

Operating status

Operating

Short description

California Health & Wellness was a Sacramento-based Medi-Cal managed care health plan, subsidiary of Centene Corporation, serving Medicaid-eligible residents across 19 California counties. The plan ceased Medi-Cal operations on January 1, 2024, with members transitioned to other health plans.

Ownership category

akta.pro rank

Product category

Medicaid Managed Care

NAICS

Health and Welfare Funds (525120)

SIC

Hospital & Medical Service Plans (6324), Services-Health Services (8000)

akta.pro primary industry

TANF/CHIP Managed Care Plans (HLAEAEAA)

akta.pro secondary industry

Integrated Physical-Behavioral-Social Care (Whole-Person) Medicaid Plans (HLAEAEAI)

Keywords

• Medicaid managed care
• Medi-Cal health plan
• Government healthcare programs
• Managed care services
• Medicaid insurance plans

Headquarters

HQ city

Sacramento

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2C

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales, Supply Chain

Revenue model

1. Capitated Medi-Cal Managed Care Premiums: The company received per-member-per-month (PMPM) capitated payments from the California Department of Health Care Services (DHCS) to administer Medi-Cal managed care benefits. Premium payments were based on enrolled member counts across contracted California counties. The plan ceased receiving Medi-Cal premiums after December 31, 2023.

Pricing tiers

Go-to-market motion1 record

Distribution channels3 records

Marketing channels3 records

Core offering

California Health & Wellness operated as a Medi-Cal managed care health plan in California, administering comprehensive Medicaid benefits to eligible low-income individuals and families across 19 counties. The plan received capitated per-member-per-month payments from the California Department of Health Care Services (DHCS) to deliver medical, behavioral health, prescription drug, dental, vision, transportation, and care coordination services through a contracted provider network. The plan ceased Medi-Cal operations effective January 1, 2024, with members transitioned to other health plans based on county of residence.

Product overview

California Health & Wellness was a California Medicaid (Medi-Cal) managed care health plan that ceased serving Medi-Cal members as of January 1, 2024. The company operated as a core Medi-Cal Plan offering comprehensive medical coverage including hospital services, physician care, preventive services, prescription drugs, mental health, and dental services. The product portfolio also included multiple CalAIM-enabled modules: Enhanced Care Management (ECM) for members with complex health needs, Community Supports offering 14 types of social services, and Community Health Workers for health navigation. Additional member support programs included disease management (via Envolve PeopleCare), the Start Smart for Your Baby prenatal program, MemberConnections outreach, and interpreter services. Provider-facing tools included a secure provider portal for eligibility verification and prior authorizations, provider training microlearnings, and billing manuals. The company also participated in the CalAIM Incentive Payment Program providing funding to build ECM and Community Supports infrastructure. Technical integrations were available via FHIR-based Patient Access API and Provider Directory API through Centene's Partner Portal for interoperability compliance. Transportation and vision benefits were managed through third-party partners including LogistiCare and Envolve Vision Care.

Differentiator

Problem solved

Functional benefit

Products and services

• Medi-Cal Plan

Segments1 record

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

Yes

API docs

API detail

Core technology

AI maturity

App detail

Integration8 records

Feature4 records

Partnerships

Six partnerships are on record, tiered core.

• PaySpan HealthcoreTechnology or IntegrationPaySpan Health provides electronic funds transfer (EFT) and electronic remittance advice (ERA) services for provider payments. The platform enables paperless claim payments, HIPAA 835 remittance file downloads, and online remittance retrieval at no cost to providers.
• Envolve Vision CarecoreTechnology or IntegrationEnvolve Vision Care manages the vision benefit for California Health & Wellness members, covering eye exams, glasses, frames, lenses, and therapeutic contact lenses.
• LogistiCarecoreTechnology or IntegrationLogistiCare manages non-emergency medical transportation (NEMT) services for members, providing transportation to medical appointments via auto, van, taxi, or wheelchair-accessible vehicles.
• NIA (National Imaging Associates)coreTechnology or IntegrationNIA manages high-tech radiology benefits including MRI, MRA, CAT, and PET imaging services for California Health & Wellness members.
• Medi-Cal RxcoreTechnology or IntegrationCalifornia Department of Health Care Services administered prescription drug benefit (Medi-Cal Rx) covering medications prescribed to Medi-Cal managed care members.
• Envolve PeopleCarecoreTechnology or IntegrationEnvolve PeopleCare provides disease management services for California Health & Wellness members, with health coaches specializing in asthma, diabetes, congestive heart failure, hypertension, smoking cessation, weight management, and back pain.

Scale indicators2 records

Recent moves4 records

Direct peers

• L.A. Care Health Plan: L.A. Care is a public, locally-controlled Medi-Cal managed care plan serving Los Angeles County. It is the largest Medi-Cal plan in California by enrollment and operates the same capitated, DHCS-regulated model as California Health & Wellness, with comparable member benefit designs and CalAIM-aligned programs.
• Partnership HealthPlan of California: Partnership HealthPlan operates as a county-organized Medi-Cal managed care plan across 24 Northern California counties — overlapping geographically with several counties served by California Health & Wellness (e.g., Butte, Colusa, Glenn, Nevada, Plumas, Sierra, Sutter, Tehama, Yuba). Directly comparable capitated Medi-Cal model.
• Molina Healthcare of California: Molina Healthcare is a national Medicaid managed care operator with a substantial California Medi-Cal presence, providing capitated benefits to low-income populations under the same DHCS regulatory framework as California Health & Wellness. Operates county-based Medi-Cal plans with similar member benefit structures.
• Kaiser Permanente Medi-Cal: Kaiser Permanente operates a major Medi-Cal managed care plan in California with an integrated care delivery model. While its provider integration is unique among peers, it competes for the same Medi-Cal enrollee population under DHCS contracts in overlapping counties.
• Inland Empire Health Plan (IEHP): IEHP is a locally-controlled Medi-Cal managed care plan serving Riverside and San Bernardino counties. It is a top-tier competitor in California's county-based Medi-Cal market with capitated PMPM revenue and care coordination programs directly comparable to California Health & Wellness's offerings.
• Santa Clara Family Health Plan: Santa Clara Family Health Plan is a locally-controlled, community-based Medi-Cal managed care plan serving Santa Clara County. It operates the same capitated model with CalAIM-aligned programs serving Medi-Cal-eligible residents in California.
• Aetna Better Health of California: Aetna Better Health operates a Medi-Cal managed care plan in California under CVS Health, providing capitated managed care benefits to Medi-Cal beneficiaries. Competes for the same enrollee population under the same DHCS regulatory framework as California Health & Wellness.
• CalOptima: CalOptima is a county-organized health system that operates as a Medi-Cal managed care plan in Orange County. It runs the same capitated, DHCS-regulated model for low-income Californians with comparable CalAIM-aligned ECM and Community Supports infrastructure.
• Anthem Blue Cross Medi-Cal: Anthem Blue Cross operates one of the largest Medi-Cal managed care plans in California with comprehensive medical, behavioral, and care coordination benefits. It competed head-to-head with California Health & Wellness for enrollees in shared counties and has the same capitated PMPM revenue model under DHCS contracts.
• Health Net (California): Health Net is the primary Medi-Cal managed care plan in California under Centene Corporation — the same parent company as California Health & Wellness. Health Net actually absorbed California Health & Wellness's members during the January 2024 transition, making it the most directly comparable peer in product, contract structure, and beneficiary profile.

Market position

Strengths3 records

Weaknesses5 records

Competitive moat3 records

Key risks5 records

Key highlights5 records

Customer concentration

• Xx.com/cahandw
• Facebookfacebook.com/CAHealthandWellness

Revenue estimate

Valuation estimate

Number of profiles

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about California Health & Wellness