SCOTTS VALLEY >> When Alan McKay started 22 years ago as CEO of a nonprofit health plan, he said he felt an immense responsibility overseeing a $50 million organization serving 27,000 low-income members who otherwise might seek treatment at a hospital emergency room.
Today, the Central California Alliance for Health is a $1.1 billion organization with 525 employees and nearly 8,000 medical providers serving 349,000 Medi-Cal recipients in three counties.
The alliance won the state’s top award for quality of care as membership grew by 52 percent to 68,000 people in Santa Cruz County, 156,000 in Monterey County and 126,000 in Merced County — all driven by the Affordable Care Act.
With policy changes in Washington after the 2016 election, that sort of growth is not on the horizon, but McKay, 65, retired Wednesday with confidence in the future of the health plan.
His successor, chosen after a nationwide search that attracted 80 candidates, is Stephanie Sonnenshine, 42, who spent the past two-and-a-half years as the alliance chief operating officer.
“Everyone has so much respect for what Alan has built,” she said. “I’m just proud to carry that forward.”
Under McKay’s leadership, the alliance:
• Increased the number of primary care and specialty providers from fewer than 1,000 to nearly 8,000.
• Linked each health plan member to a primary care provider.
• Created an incentive program to reward providers for best practices.
• Awarded 373 grants totaling $62 million to boost availability of health care services.
In November, McKay received the “Community Impact Award” from the Monterey Bay Economic Partnership.
Santa Cruz County Supervisor Ryan Coonerty, who chairs the Alliance governing board, called McKay a visionary for designing a new model of health care, and Elisa Orona, who heads the Health Improvement Partnership of Santa Cruz County, cited McKay’s leadership in addressing upstream factors in health outcomes such as hunger, walkability and housing.
“Our model is like the single-payer model,” McKay said, noting nearly all members are eligible for coverage through the state’s Medi-Cal program. “We do not need to spend advertising dollars (to enroll members). We invest in member services.”
DATA DRIVEN
An analysis, he said, found 8 percent of alliance members accounted for 75 percent of medical expenses.
That’s 28,000 people driving $750 million in medical costs, he said. Digging deeper, he learned 70 percent of these members had behavioral health or substance abuse disorders.
This led to the new “navigator” initiative late last year to reduce repeat use of emergency departments at four hospitals, including Dignity Health Dominican Hospital in Santa Cruz. A patient advocate will meet with alliance members who have multiple medical conditions while they are at the hospital to make sure they know they have a primary care provider and help arrange transportation to future appointments.
“What better place to do that than the ER?” McKay said.
POTENTIAL
Sonnenshine, who lives in Live Oak, started at the alliance as a temp 13 years ago after getting her degree from UC Santa Barbara.
She said she envisioned getting a master’s degree in public health, but stayed at the alliance, becoming McKay’s executive assistant, clerk of the alliance governing board, then working on contracts for the health plan.
That led her to complete law school and specialize in family law. When she realized she didn’t enjoy litigation, she applied and got a position at the alliance as provider services director, developing the incentive program for best practices.
She became compliance director, using her legal background, and then in 2015 chief operations officer.
“She saw the potential in people,” McKay said. “She wanted to give them the responsibility and also the support to grow.”
He added, “She’s kind of a beacon in a storm, calm… a great communicator, always leading with integrity.”
Sonnenshine said the alliance mission, providing cost-effective access to health care for the members, will not change but she expects technology will be a part of the solution. Toward that end, the alliance recently convened focus groups of members to ask for their input on member communications.
“People want to be able to use their smartphone,” she said.
CENTRAL CALIFORNIA ALLIANCE FOR HEALTH
What: Award-winning nonprofit health plan serving nearly 350,000 members in Santa Cruz, Monterey and Merced counties.
Members: Seniors, persons with disabilities, low-income mothers and their children, pregnant women, home care workers caring for elderly and disabled, low-income childless adults; 47 percent are children up to age 18.
CEO: Stephanie Sonnenshine.
Annual revenue: $1.1 billion.
Employees: 413 in Scotts Valley, 65 in Merced, 47 in Salinas.
Physician providers: 7,985.
Recognition: Quality awards from state Department of Health Care Services, 2012, 2013, 2014, 2016.