HPSM was created in 1987 to address access to preventive care for Medi-Cal beneficiaries. During the 1980’s, Medi-Cal beneficiaries were increasingly using local emergency rooms for primary care and pregnant women were seeking care in nearby counties because they could not find local providers participating in Medi-Cal.
In response to this local healthcare crisis, the San Mateo County Board of Supervisors created the San Mateo Health Commission. As a result, on December 1, 1987, Health Plan of San Mateo (HPSM) was established as a County Organized Health System. Our mandate: to offer a comprehensive network of providers and promote preventive care for Medi-Cal beneficiaries.
HPSM started with 28,000 Medi-Cal recipients. Today, we serve more than 160,000 San Mateo County residents through various health programs and initiatives.
On December 1st, HPSM opens as a County Organized Health System to offer a comprehensive network of providers and promote preventive care for 28,000 Medi-Cal beneficiaries.
HPSM joins the Healthy Families program (California’s version of the federal State Children’s Health Insurance Program). This provides a low-cost health insurance option for children of families with incomes too high to qualify for Medi-Cal but still below 250% of the federal poverty level.
HPSM partners with the San Mateo County Health System to offer affordable health insurance to low-income kids, including undocumented kids, who are not eligible for other health insurance options.
San Mateo County Access to Care for Everyone (ACE)
HPSM partners with the San Mateo County Health System to offer health coverage to low-income adults, including undocumented adults, not eligible for Medi-Cal or other health insurance options.
California Children's Services Pilot (CCS)
HPSM partners with the San Mateo County Health System and Lucile Packard Children’s Hospital to become the first county in the state to pilot an integrated care model for kids with complex medical conditions in the California Children’s Services program.
With the passage of the federal Affordable Care Act of 2010 and the support of the State of California, HPSM expands Medi-Cal coverage and benefits to include all individuals with income up to 138% of the federal poverty level. This allows HPSM to offer comprehensive health care through our Medi-Cal program to individuals who previously were uninsured or underinsured.
CareAdvantage Cal MediConnect (CMC)
In partnership with the Federal Center for Medicare and Medicaid Services and the State Department of Health Care Services, HPSM and San Mateo County launch a CareAdvantage demonstration program to better coordinate care and services for beneficiaries with both Medicare and Medi-Cal.
Healthy at Home programs
HPSM implements the first of many initiatives for high-risk, chronically ill members to reduce hospitalizations and long-term care stays so they can live and thrive where they most want to be – at home. The Community Care Settings Program began by helping members transition from skilled-nursing facilities back to their own homes with appropriate medical care and social supports. The HomeAdvantage program provides routine home visits and 24/7 access to an interdisciplinary care team.
HPSM begins covering "mild to moderate" behavioral health issues.
COVID-19 vaccine support
As COVID-19 vaccines become available, HPSM helps our highest-risk members get vaccinated.
HPSM Dental becomes California State's first-ever dental plan for Medi-Cal members that is fully integrated with medical and behavioral health care benefits.
HPSM locally executes California Advancing and Innovating Medi-Cal (CalAIM). This statewide program covers new types of care for the highest-need Medi-Cal members, including Enhanced Care Management (ECM) and Community Supports. Two innovative pilot programs that HPSM pioneered for the State of California— Whole Person Care (WPC) and the Health Homes Program (HHP)—became key parts of what CalAIM is modeled on.
HPSM launches CareAdvantage D-SNP, a Dual Eligible Special Needs plan for HPSM Medi-Cal members who have Medicare Parts A & B.