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As pandemic retightens grip, Orange County’s largest health insurer names new leader

Richard Sanchez is the chief executive of CalOptima.
Richard Sanchez has been named the chief executive of Orange County’s largest health insurer, CalOptima.
(Courtesy of CalOptima)

Richard Sanchez has been named the permanent replacement to lead Orange County’s largest health insurer as the pandemic once again grips the county.

Sanchez had been serving as the interim chief executive for CalOptima since early May after leaving his role as the director of the Orange County Health Care Agency.

There was controversy surrounding Sanchez’s departure from the leading health position in the county as it wrestled with the beginning months of the coronavirus pandemic and the politicization of masks.

Sanchez, who served on the board of CalOptima, takes the reigns as the insurer’s membership numbers increase, lifted by residents facing new financial hurdles amid the pandemic economy. CalOptima serves the poor and homeless with Medi-Cal in Orange County.

“We’re anticipating that the financial hits that are being seen across Orange County are going to take its toll in terms of the population meeting criteria to be Medi-Cal eligible, and the signup may be ticking upwards,” Sanchez said.

Membership has grown by about 70,000 between February and October from 709,000 to 776,000. The county’s unemployment rate climbed to as high as 14.7% in May before tapering down to about 9% in September, according to CalOptima data.

State officials placed Orange County back into its bottom-most, purple tier as coronavirus cases spike throughout California. About 94% of Californians now live in the strictest tier.

Sanchez said the most difficult aspect of the new world under COVID-19 has been transitioning to telehealth for both employees and patients.

“The virtual nature of telehealth and transitioning to that very quickly and all the impacts that it’s had on basically the health world, I mean I can just go on and on with that one,” Sanchez said.

Sanchez said it was a “heavy lift” switching from in-person to telehealth. CalOptima doesn’t provide direct care, rather it provides care through its network.

Sanchez said it was easier for some of CalOptima’s national health provider partners to transition over to telehealth, but it has been far more difficult for smaller community clinics to redefine how they provide healthcare through retraining staff and the expenses that went along with the transition.

There’s still room for improvement.

“We’ve made headway in acceptance and usage,” Sanchez said. "... Not at the same level where I feel our preventative care, our ongoing natural care of chronic conditions is where it should be.”

Sanchez said member acceptance of the new telehealth system is a major issue. Since CalOptima is the county’s healthcare provider for the poor and homeless, members may lack a computer or the technical knowledge to navigate the telehealth system.

“Our senior citizens may struggle with that and may be more vulnerable because of that,” Sanchez said.

A picture of a homeless man in Costa Mesa in January 2019.
A homeless man in Costa Mesa in 2019.
(Raul Roa / Staff Photographer)

Sanchez also said he will work to put the millions of dollars earmarked for homelessness programs to use.

Board of Supervisors Vice Chair Andrew Do, who serves on the board of CalOptima, was critical of the insurer while it was under the leadership of Sanchez’s predecessor, Michael Schrader for moving “too slowly” in rolling out programs to help the homeless.

“I am very frustrated,” Do said in 2019. “It’s to the point where they are either tone deaf or they don’t know what the heck they are doing.”

Despite requests for an interview this week, Do only provided an emailed statement.

“The CalOptima Board is excited to appoint Richard Sanchez as the permanent CEO,” Do said in the statement.

“Richard’s 36 years of experience in healthcare, together with his strong leadership at HCA and as interim CEO for CalOptima through the difficult challenges of COVID the past seven months, will allow him to be a strong leader in delivering a member-focused health care system centered on quality, increased access and equity.”

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