L.A. County free clinic sys­tem to use med­i­cal-home model

Modern Healthcare - - REGIONAL NEWS - —Adam Ruben­fire

Los An­ge­les County is ex­pand­ing and over­haul­ing its free health pro­gram for low-in­come, unin­sured res­i­dents. It’s one of very few in the U.S. that ex­tends health­care to res­i­dents liv­ing in the U.S. il­le­gally and thus don’t qual­ify for the cov­er­age op­tions un­der the health­care re­form law.

To re­duce episodic use of the sys­tem, par­tic­i­pants will now be re­quired to ex­clu­sively use one clinic for all of their pri­mary-care needs un­der a med­i­cal-home model. Un­der My Health L.A., the county will now pay clin­ics a monthly fee of $32 per pa­tient. In the past, unin­sured county res­i­dents could get care at a net­work of over 160 com­mu­nity clin­ics, and the county would pay the clin­ics a per-ser­vice fee.

Any­one liv­ing in the county who makes less than 138% of the fed­eral poverty level and can’t get in­surance or en­roll in Med­i­caid can sign up for the pro­gram. Par­tic­i­pants can get hos­pi­tal and emer­gency care at hos­pi­tals op­er­ated by the L.A. County Depart­ment of Health Ser­vices.

Tan­ger­ine Brigham, deputy di­rec­tor of man­aged-care ser­vices for the depart­ment, said she and her team want to cre­ate a sys­tem in which pa­tients will have a con­sis­tent source of pri­mary care—a spe­cific physi­cian or team that would know the pa­tient’s his­tory and be equipped to ad­min­is­ter pre­ven­tive ser­vices to keep the pa­tients out of hos­pi­tal emer­gency rooms.

L.A. County pa­tients will be re­quired

to get their pri­mary care at one clinic.

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