Tuesday, April 13, 2010

Molina Leads Effort to Transition L.A. County as National Health Care Takes Effect




FOR IMMEDIATE RELEASE CONTACT:  Roxane Marquez at (213) 974-4111 (office) or (213) 598-5463 (cellular)




‘Medi-Cal Patients Will Flood Our System—and We Can’t Afford to Lose Them’


LOS ANGELES (April 13, 2010)—Los Angeles County Board of Supervisors Chair Gloria Molina and her colleagues directed the county’s Chief Executive Officer to move forward with recommendations by Health Management Associates and hire L.A. Care to help the county transition seamlessly as national health care reform takes effect.

 “Today’s action is absolutely essential,” Molina said.  “As the Obama Administration implements national health care, it will affect us profoundly—and Los Angeles County’s public health care network must evolve and transition.  In just four years, thousands of patients who formerly lacked health care coverage will be paying health insurance customers.  Medi-Cal patients will flood our system—and we cannot afford to lose them.  Otherwise, we will end up being just a set of emergency rooms and a few clinics caring only care for the indigent and the most ill among us, while paying customers go to other plans.  That set-up can’t sustain itself—and it’s an outcome we can avoid.  Los Angeles County has some of the best specialty units in the state.  Once patients our patients see a doctor or nurse, for the most part, they receive high-quality care.  But how our patients actually get to their health care provider is not properly managed.  So as America moves forward with national health care, it’s the perfect time for us to reconfigure Los Angeles County’s health care system with the end goals of profitability and better management of patients.”

The Board of Supervisors originally hired Health Management Associates in December 2009 to conduct an independent, top-to-bottom review of the county’s Department of Health Services (DHS) —and, specifically, to provide suggestions on how the county could benefit from national health care reform opportunities by April 2010.  (Supervisors also hired The Abaris Group to review the county health department’s medical malpractice procedures; that report is due next month.)   In addition to four emergency rooms, Los Angeles County currently provides health care to uninsured individuals via a public-private partnership (PPP) health care program comprised of more than 130 participating clinics that collectively receive $56 million annually from the county to administer services.  During 2008, PPP clinics provided services to 178,000 patients during 560,182 doctor’s visits according to DHS.

Health Management Associates’ report ultimately concluded that:

·         A large number of previously uninsured individuals will be added to Medi-Cal rolls as a result of national health care reform—and a significant portion of those individuals will be assigned to managed care plans.

·         DHS currently is not well-positioned to retain those patients who, if transitioned to Medi-Cal managed care, could choose to obtain their health care from outside the county’s system.

·         The county health department’s Office of Managed Care (OMC)/Community Health Plan (CHP) does not have the personnel, expertise, or resources to develop a managed care approach—but L.A. Care, whose mission is to “protect the community safety net,” does.

The report also recommended that L.A. Care work with the county’s Chief Executive Office and DHS to formulate a new safety net delivery system comprised of the health department, community clinics/PPP clinics, other safety net hospitals, and behavioral health providers.  Ultimately—should negotiations prove successful—DHS would no longer directly manage patients’ health care via the OMC/CHP.

A status report on the structure of Los Angeles County’s new safety net delivery system should be presented to the Board of Supervisors in six months.



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