Toby Douglas


Director, California Department of Health Care Services (2011-2015)


Mr. Douglas was named director of the California Department of Health Care Services in January 2011, a post he held till January 2015. During his tenure, he managed a budget of over $37 billion, and a workforce of approximately 1,700 employees. He was responsible for setting Medi-Cal policy, operation of the Medi-Cal payment systems, operation of the Medi-Cal field offices, and oversight of the Medi-Cal Managed Care program. Mr. Douglas was also responsible for the Children’s Medical Services and Primary and Rural Health programs.  He played a major role in formulating the health care program’s benefits and eligibility policies, and was responsible for overall coordination and direction of the healthcare delivery systems for over seven million beneficiaries, almost half of whom are children.   

Mr. Douglas joined the Medi-Cal program in September 2005 as the assistant deputy director for Medical Care Services for the California Department of Health Services. Before joining the State, Mr. Douglas was the deputy director of the San Mateo County Health Department, where he was responsible for the activities related to health access, policy, and planning. Previously, Mr. Douglas was a research associate at the Urban Institute, a non-partisan, social policy research organization in Washington, DC. 

Mr. Douglas earned a master’s in public health and a master’s in public policy from the University of California, Berkeley.

Leadership Project

Goal: Develop a strategic plan that transforms Medi-Cal into a value-based system that will lead to better quality, outcomes, and performance of the health care system.

Toby Douglas sought to ensure that both the Medi-Cal fee-for-service and managed care systems use performance incentive strategies to pay for outcomes, invest in prevention, align financing, and encourage providers to effectively use health information technology. With his senior staff, Mr. Douglas identified the California Children’s Services (CCS) program as the first area to implement a value-based approach within Medi-Cal. In collaboration with the CHCS and Professor Michael Porter of the Harvard Business School, Mr. Douglas and his team assessed the viability of incorporating value-based purchasing into various payment systems and are creating a plan for implementing these concepts into the CCS program for specific medical conditions. 

Related Resources

Advancing Innovations in Health Care Delivery for 11 Million+ Californians: See a video and profile detailing the role of California’s Medicaid Director Toby Douglas in leading innovations to improve the nation’s largest state Medicaid program.