Choc Health Alliance

Name

Choc Health Alliance

Legal name

CHOC Health Alliance

Website

https://chochealthalliance.com

Company type

Private

Operating status

Operating

Headcount range

11–50 employees

Ownership category

akta.pro rank

Product category

Pediatric Managed Care Network

NAICS

Child and Youth Services (62411), Specialty (except Psychiatric and Substance Abuse) Hospitals (622310), Other Individual and Family Services (624190)

SIC

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

akta.pro primary industry

Children’s Hospitals & Pediatric Health Systems (HLAFAJAG)

akta.pro secondary industry

Public Health & Health Equity Organizations (BPAGACAL)

Keywords

• Pediatric health network
• Managed care services
• Medi-Cal healthcare
• Care coordination
• Provider network management

Headquarters

HQ city

Orange

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2C

Offering type

Services

Cost components

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

Revenue model

1. Medi-Cal Capitated Payments: As a regulated pediatric health network under CalOptima Health, CHOC Health Alliance receives capitated (per-member-per-month) payments from the state Medi-Cal program to manage the healthcare of enrolled children and young adults (ages 0-21).

Go-to-market motion1 record

Distribution channels1 record

Marketing channels2 records

Core offering

CHOC Health Alliance is a regulated pediatric health network that delivers and coordinates Medi-Cal healthcare services for children and young adults (ages 0-21) in Orange County, California. It contracts with CHOC Children's Hospital, CHOC at Mission Hospital, and a broad roster of specialty, DME, home health, radiology, and therapy providers, while offering members care coordination, a 24/7 nurse advice line, and an Enhanced Care Management (ECM) program.

Product overview

CHOC Health Alliance operates as a pediatric health network providing healthcare for children and young adults from birth up to 21 years of age in Orange County. The network is regulated by CalOptima Health and is anchored by its relationship with CHOC Children's Hospital and CHOC at Mission Hospital. The core offering consists of member services (including benefit information, provider finding, and care coordination), a contracted provider network, and supplementary tools including a Quality Improvement Advisor program and Provider Roster directories. Member-facing services include a 24/7 Pediatric Nurse Advice Line and Enhance Care Management (ECM) for eligible Medi-Cal members. Provider tools encompass authorization, claims, HEDIS quality measures, and compliance resources. These components work together to deliver coordinated pediatric care under the Medi-Cal program.

Differentiator

Problem solved

Functional benefit

Products and services

• CHOC Health Alliance Member Services Comprehensive member services for Medi-Cal-enrolled children and young adults (ages 0-21) in Orange County, including benefit information, provider finding, urgent care access, hospital network navigation across CHOC Children's Hospital and CHOC at Mission Hospital, a 24/7 nurse advice line, case management, and Enhanced Care Management for eligible members.
• Provider Network Contracted pediatric healthcare provider network in Orange County, anchored by CHOC Children's Hospital and CHOC at Mission Hospital and including specialty, DME, home health, radiology, and therapy providers serving Medi-Cal members aged 0-21. Regulated by CalOptima Health.
• Enhance Care Management (ECM) No-cost care coordination service for eligible CHOC Health Alliance Medi-Cal members, connecting families to medical care, behavioral health services, school support, and essential community resources across a whole-person care model.
• 24-Hour Pediatric Nurse Advice Line Free 24/7 pediatric nurse advice line staffed by pediatric healthcare experts with the ability to escalate to virtual visits with a physician, available to CHOC Health Alliance members and families.

Segments2 records

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Partnerships

Six partnerships are on record, tiered core, major and minor.

• CalOptima HealthcoreStrategic or Co-development PartnerCalOptima Health is a public healthcare agency that regulates and partners with CHOC Health Alliance. CalOptima assigns Medi-Cal members to the CHOC Health Alliance network and provides oversight and funding for the pediatric healthcare services provided.
• CHOC Children's HospitalcoreStrategic or Co-development PartnerCHOC Children's Hospital is the flagship contracted hospital partner of CHOC Health Alliance, providing specialized pediatric inpatient and emergency services for CHA members in Orange County.
• CHOC Children's at Mission HospitalcoreStrategic or Co-development PartnerCHOC Children's at Mission Hospital is a contracted hospital partner providing pediatric healthcare services for CHA members in the Mission Viejo area of Orange County.
• California Department of Health Care Services (DHCS)coreStrategic or Co-development PartnerDHCS is the state agency overseeing California's Medi-Cal program, which funds the healthcare services provided by CHOC Health Alliance to eligible children and young adults.
• California Children's Services (CCS)majorStrategic or Co-development PartnerCCS is a statewide program that provides diagnostic and treatment services for children with certain eligible medical conditions. CHOC Health Alliance connects members to CCS services as part of comprehensive care coordination.
• Child Health and Disability Prevention Program (CHDP)minorStrategic or Co-development PartnerCHDP provides health assessment services for children. CHOC Health Alliance coordinates with CHDP for preventive care services for its member population.

Scale indicators1 record

Recent moves5 records

Expansion highlights4 records

Broad incumbents

• Molina Healthcare: National managed care company with substantial Medi-Cal presence in California, contracting with delegated networks for pediatric populations. Comparable capitated managed care model with delegated network architecture.
• CalOptima Health: Public County Organized Health System that contracts with and assigns members to CHOC Health Alliance. Operates the broader Medi-Cal plan of which CHA is a delegated pediatric network — comparable managed care function at the plan level rather than delegated network level.
• LA Care Health Plan: Largest public Medi-Cal managed care plan in California, contracting with CHLA Health Alliance and similar pediatric delegated networks. Operates the same Medi-Cal capitated model as CalOptima, providing structural comparability.
• Inland Empire Health Plan (IEHP): Large public Medi-Cal managed care plan serving Riverside and San Bernardino counties with delegated pediatric arrangements. Comparable Medi-Cal capitated plan structure with pediatric delegated networks.
• Partnership HealthPlan of California: County-organized Medi-Cal managed care plan serving Northern California with delegated network arrangements including pediatric providers. Comparable Medi-Cal capitated, public-agency-regulated model.
• Health Net: Large commercial and Medi-Cal managed care plan operating across California, contracting with delegated networks including pediatric-focused entities. Comparable capitated managed care model at broader scale.
• Valley Children's Healthcare: Central California pediatric health system with hospital and clinically-integrated network operations serving Medi-Cal children. Comparable pediatric specialty anchor with Medi-Cal capitated arrangements.

Direct peers

• CHLA Health Alliance: Operates a pediatric delegated network under L.A. Care Health Plan for Medi-Cal children in Los Angeles County, mirroring CHA's structure under CalOptima. Direct structural twin: capitation, pediatric-only, anchored by a children's hospital (CHLA).
• Rady Children's Health Network: Pediatric clinically-integrated network anchored by Rady Children's Hospital in San Diego, serving Medi-Cal children through delegated arrangements with San Diego County Medi-Cal plans. Comparable pediatric focus, hospital anchor, and capitated model.

Others

• CHOC Children's Hospital: Flagship hospital partner of CHOC Health Alliance, providing pediatric inpatient and emergency services for CHA members. Not a competing network but the indispensable clinical partner whose brand and capacity underpin CHA's value proposition.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat4 records

Key risks6 records

Key highlights6 records

Customer concentration

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 Choc Health Alliance