Value-Based Care in California: What DMHC Expects
California has the deepest delegated-risk market in the country. Here is a practical primer on the regulatory expectations that shape it.
California's delegated model is unusually mature, which means the regulatory expectations are unusually specific. If you operate here, the DMHC framing matters.
What regulators look for
- Clear financial responsibility between plans and delegated groups.
- Timely, accurate claims payment.
- Solvency and oversight of the risk-bearing organization.
Getting the DOFR right is not just good operations here. It is part of staying compliant.