Our Financial Outlook for 2026

Dear Colleagues:

As Contra Costa Health enters a period of rapid change, I am sharing what we know and how we are preparing for the months ahead. New state and federal policies will alter eligibility, reimbursement, and the landscape in which we deliver care.

CCH faces significant financial pressure. We project these changes will reduce our revenue by more than $330 million over four years, including major cuts in supplemental payments and fee-for-service reimbursement. At the same time operating expenses, labor costs, and required capital projects continue to rise.

These forces will affect how we operate. As Med-Cal eligibility changes take effect, Contra Costa Health Plan may lose as many as 100,000 members, meaning more residents will be uninsured.

This increases demand for our services at a time when reimbursement will be falling, which is why strengthening operations and spending wisely is essential.

To manage these pressures responsibly, we are taking steps across the department to operate more efficiently and reduce costs without reducing essential services. This includes improving staffing models, strengthening billing and revenue processes, reducing external spending, and finding better ways to use our space, technology and supplies. These efforts are already underway, and many of you are contributing to them.

Our goal is to stabilize our finances while protecting the services our community relies on and the workforce that delivers them. The work we are doing now will help us manage and mitigate these state and federal changes.

Later this month, we will present this financial outlook in detail to the Board of Supervisors. Sharing this information publicly is an important part of my commitment to transparency and responsible planning.

We will continue to communicate as openly as possible as the policy landscape evolves. Through all this, our mission remains the same. Contra Costa Health has weathered major transitions before by staying grounded in service, compassion, and the needs of our community. I am confident we will do the same in the year ahead.

Thank you for everything you do each day. Your work matters deeply, and it is the foundation of our ability to navigate this moment together.

With deep respect,

Grant Colfax, MD
Chief Executive Officer
Health Director, Contra Costa County