County Medical Services Program

What County Medical Services Program does

The County Medical Services Program (CMSP) is a California joint powers authority created under California Welfare and Institutions Code Sections 16809 and 16809.4 and administered by the CMSP Governing Board, which represents 35 participating California counties spanning nearly 90,000 square miles. Founded in 1983 and headquartered in Sacramento with a small staff of 10-15 administrative personnel, CMSP provides health coverage to uninsured low-income indigent adults aged 21-64 who are not eligible for Medi-Cal or other publicly funded healthcare programs, with eligibility extending to incomes up to 300% of the Federal Poverty Level regardless of immigration status.

CMSP's product portfolio includes the core CMSP Benefit (comprehensive inpatient, outpatient, emergency, dental, vision, mental health, and prescription drug coverage), the Connect to Care preventive and primary care program launched in December 2020 for residents at 138-300% FPL, and a suite of healthcare workforce development programs (Building the Healthcare Workforce Grant, Loan Repayment Programs up to $50,000, four scholarship tracks, Healthcare Infrastructure Development Matching Grants up to $500,000, and Local Indigent Care Needs Grants up to $1.5 million). Program technology is delegated entirely to third-party administrators: Advanced Medical Management handles medical and dental benefits administration, MedImpact Healthcare Systems manages pharmacy benefits, CalSAWS supports eligibility processing, and BenefitsCal provides online application infrastructure.

The program's revenue model is non-commercial, funded through contributions from its 35 participating counties alongside state and federal healthcare funding allocations rather than member premiums. Enrollment occurs through county social services departments, participating community health centers, and the BenefitsCal online portal. Distribution leverages the full county social services infrastructure across the 35-county service area, and the program's competitive position is anchored in statutory authority, established county partnerships, and contracted provider networks with Advanced Medical Management and MedImpact.

Name

County Medical Services Program

Legal name

County Medical Services Program Governing Board

Website

https://cmspcounties.org

Company type

Private

Founded year

1983

Operating status

Operating

Headcount range

1–10 employees

Short description

The County Medical Services Program (CMSP) is a California joint powers authority that provides health coverage to uninsured low-income indigent adults aged 21-64 across 35 California counties who are not eligible for Medi-Cal, operated through a Governing Board representing participating counties.

Ownership category

akta.pro rank

Product category

Public Health Insurance / Government Healthcare Program

NAICS

Social Assistance (624)

SIC

Hospital & Medical Service Plans (6324)

akta.pro primary industry

Medicaid/CHIP Dental & Vision Benefits Administration (FSAIAHAK)

Keywords

• Public health coverage
• Indigent healthcare program
• County medical services
• Healthcare workforce grants
• Preventive care benefits

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, Supply Chain, Others

Revenue model

1. County Contributions and State/Federal Funding: CMSP is funded through contributions from 35 participating California counties along with state and potentially federal funding mechanisms. The Governing Board sets annual budgets and provider reimbursement rates within the context of program revenues and expenditures.

Pricing tiers

Go-to-market motion2 records

Distribution channels5 records

Marketing channels4 records

Core offering

CMSP is a government-administered healthcare coverage program that provides comprehensive medical, dental, vision, prescription, mental health, and emergency benefits to uninsured low-income indigent adults in 35 California counties who are not eligible for Medi-Cal. It also operates the Connect to Care preventive care program, plus healthcare workforce development grants, loan repayment, and scholarship programs administered through HCAI.

Product overview

County Medical Services Program (CMSP) operates as a unified healthcare benefit program delivered through multiple coordinated components: the core CMSP Benefit Program provides comprehensive inpatient and outpatient coverage for uninsured low-income adults in 35 California counties; Connect to Care offers preventive and primary care for residents at 138-300% FPL; and a suite of Healthcare Workforce Development grants (including Building the Healthcare Workforce, Loan Repayment, Scholarships, HID Matching, and LICN grants) supports healthcare provider recruitment and retention. Program administration is handled through contracted partners Advanced Medical Management (medical/dental) and MedImpact Healthcare Systems (pharmacy), with enrollment via county social services departments, participating community health centers, and the online BenefitsCal portal.

Differentiator

Problem solved

Functional benefit

Brands

• Connect to Care: A program providing preventive and primary care health benefits to California residents ages 21-64 with income between 138-300% of Federal Poverty Level, available regardless of immigration status.
• CMSP Benefit

Products and services

• CMSP Benefit Program Comprehensive health coverage program for uninsured low-income indigent adults (ages 21-64, income up to 300% FPL) in 35 California counties who are not eligible for Medi-Cal or other publicly funded healthcare programs. Benefits include emergency services, inpatient hospital care, preventive care, primary and specialist visits, prescription drugs, dental, vision, mental health services, substance use disorder treatment, physical therapy, and medical equipment. Coverage is available regardless of immigration status.
• Connect to Care Preventive and primary care health benefits program for California residents ages 21-64 with income between 138-300% of the Federal Poverty Level who do not have Medi-Cal, Medicare, or private insurance. Available regardless of immigration status. Covers mental health services, primary care, specialist office visits, preventive health screenings, routine lab tests, adult immunizations, physical therapy, tobacco-use counseling, and prescription medications with a $5 copay per fill (up to $1,500 maximum benefit limit).
• Workforce Loan Repayment Programs Educational debt relief programs including the CMSP Loan Repayment Program (up to $50,000 for healthcare professionals in exchange for a 2-year service obligation) and the Allied Healthcare Loan Repayment Program (up to $16,000 for allied health professionals in exchange for a 1-year service obligation). Both programs are administered by the Department of Healthcare Access and Information (HCAI) on behalf of CMSP.
• Workforce Scholarship Programs Four scholarship programs administered by HCAI including ADNSP (Associate Degree Nursing Scholarship Program, up to $8,000), BSNSP (Bachelor of Science Nursing Scholarship Program, up to $10,000), VNSP (Vocational Nurse Scholarship Program, up to $4,000), and APHSP (Advanced Practice Healthcare Scholarship Program, up to $25,000). Available for students pursuing healthcare careers who commit to serve in CMSP counties.
• Building the Healthcare Workforce Grant (BHW) Grant program addressing chronic healthcare provider shortage in CMSP counties by funding coalition planning projects (up to $60,000-$85,000) and initiative grants (up to $450,000-$750,000) to expand healthcare workforce pipelines. Awarded to coalitions working to build healthcare workforce capacity in CMSP-serving counties.
• Healthcare Infrastructure Development Matching Grant (HID Matching Grant) Matching grant program (awards up to $500,000 or 5% of project cost) helping CMSP counties develop expanded facility capacity for healthcare and behavioral health services for underserved populations. The grant requires matching funds and supports physical infrastructure development for indigent care.
• Local Indigent Care Needs Grant (LICN) Grant program with two tracks: Planning Project Grants (up to $50,000-$75,000) and Implementation Program Grants (up to $1,500,000) to expand delivery of indigent care services, improve care coordination, and health outcomes for low-income adults in CMSP counties.

Quantifiable outcome

• 35 counties participating in the program
• +1 more outcomes

Named customers1 record

Segments2 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Partnerships

Seven partnerships are on record, tiered core and minor.

• Advanced Medical Management (AMM)coreImplementation/ SI/ Consulting PartnerAMM administers all CMSP medical and dental benefits on behalf of the CMSP Governing Board. Healthcare providers interested in providing services to CMSP members must enter into contracts with the CMSP Governing Board through AMM. AMM manages the provider network, prior authorizations, claims processing, and member services including grievances and appeals.
• MedImpact Healthcare Systems, Inc.coreImplementation/ SI/ Consulting PartnerMedImpact administers all CMSP prescription drug benefits provided through retail pharmacies. The organization manages the pharmacy network, drug formulary, prior authorization requirements, and prescription drug utilization controls. MedImpact also handles Direct Member Reimbursement for out-of-pocket prescription costs.
• Department of Healthcare Access and Information (HCAI)coreImplementation/ SI/ Consulting PartnerHCAI administers CMSP's workforce development programs including the CMSP Loan Repayment Program, Allied Healthcare Loan Repayment Program, and multiple scholarship programs (ADNSP, BSNSP, VNSP, APHSP). HCAI manages the application processes and award distributions for these educational debt relief and scholarship initiatives.
• 35 Participating California CountiescoreStrategic or Co-development PartnerThirty-five California counties participate in CMSP, including Alpine, Amador, Butte, Calaveras, Colusa, Del Norte, El Dorado, Glenn, Humboldt, Imperial, Inyo, Kings, Lake, Lassen, Madera, Marin, Mariposa, Mendocino, Modoc, Mono, Napa, Nevada, Plumas, San Benito, Shasta, Sierra, Siskiyou, Solano, Sonoma, Sutter, Tehama, Trinity, Tuolumne, Yolo, and Yuba. Counties provide contributions to fund the program and administer eligibility through their social services departments.
• Participating Community Health CenterscoreChannel Partner/ Reseller/ DistributorCommunity health centers throughout the 35 CMSP counties serve as enrollment providers for both CMSP and Connect to Care programs. These centers help eligible individuals apply for coverage and provide healthcare services to CMSP members.
• Rural County Representatives of California (RCRC)minorStrategic or Co-development PartnerCMSP partnered with RCRC on healthcare workforce research conducted by UCSF to assess healthcare workforce needs in CMSP and RCRC counties. This research informed the Building the Healthcare Workforce Grant program.
• University of California, San Francisco (UCSF) Healthforce CenterminorStrategic or Co-development PartnerUCSF Healthforce Center conducted healthcare workforce research for CMSP and Rural County Representatives of California. The research examined the availability of healthcare professionals including health care, oral health, and behavioral health providers in CMSP counties and educational pathways for these professions.

Scale indicators3 records

Recent moves5 records

Expansion highlights3 records

Direct peers

• CalOptima: A public, county-organized health plan serving Orange County, California through Medi-Cal managed care and other programs. Directly comparable as a California county-organized public health plan providing coverage for low-income populations, though CalOptima administers Medi-Cal while CMSP covers those not eligible for it.
• L.A. Care Health Plan: The largest public health plan in the United States, serving Los Angeles County through Medi-Cal, Cal MediConnect, and other programs. Directly comparable as a county-organized public health plan administering government-funded coverage for low-income populations in California.
• Inland Empire Health Plan (IEHP): A public, not-for-profit Medi-Cal and Medicare health plan serving Riverside and San Bernardino counties in California. Directly comparable as a county-organized public health plan providing managed care coverage for low-income populations in California's inland region.
• Partnership HealthPlan of California: A non-profit community-based health care organization administering Medi-Cal managed care across 14 Northern California counties. Comparable as a California regional public health plan serving rural and small-county populations similar to CMSP's service area.
• Central California Alliance for Health: A managed care plan serving Medi-Cal beneficiaries in Santa Cruz, Monterey, Merced, San Benito, and Mariposa counties. Comparable as a California regional public health plan serving low-income populations in mostly rural counties similar to CMSP's footprint.

Broad incumbents

• Health Net: A major California health insurer with significant Medi-Cal managed care presence through its state contracts. Comparable as a broader incumbent in California Medicaid managed care that serves similar low-income populations at greater scale across the state.
• Molina Healthcare: A large managed care organization focused on Medicaid, Medicare, and other government-sponsored healthcare programs across multiple states. Comparable as a broad incumbent in Medicaid managed care with significant California presence serving low-income and indigent populations.
• Kaiser Permanente: A major California-based integrated health system with substantial Medi-Cal membership and provider network across the state. Comparable as a broad California healthcare incumbent that participates as both payer and provider for government-funded low-income populations.

Others

• California Department of Health Care Services (DHCS): The California state agency that administers Medi-Cal and oversees county indigent health programs including CMSP. Comparable as the regulator and primary funder of California's Medicaid program, with which CMSP's coverage gaps are explicitly defined.

Emerging players

• Community Health Center Network (CHCN): A consortium of community health centers in Alameda County, California that serves as an emerging player in coordinated care for Medi-Cal populations. Comparable as it partners with CMSP for enrollment and serves similar low-income, often uninsured populations through California community health centers.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat3 records

Key risks7 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/county-medical-services-program-governing-board

Revenue estimate

Valuation estimate

Number of profiles

Profiles12 records

Funding overview

Funding rounds

Investors

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M&A

Investments

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Frequently asked questions about County Medical Services Program