CEO Statement on Recent Los Angeles Times Article:Medi-Cal Works for Most Enrollees, Survey Finds

I’m gratified to see that Medi-Cal beneficiaries believe they receive high-quality health care (May 31, 2012 LAT article by Anna Gorman).  Less gratifying, but not surprising, is that ER use is very high for this population.  It raises the question - why is the rate so high?

One explanation is that Medi-Cal recipients are sicker - income and socioeconomic status are directly linked to worse health.  Medi-Cal recipients often go to the ER because their primary doctors are not available when they are sick, and access to specialty care is even more challenging.  Further, they do not face copayments for visiting the ER the way most of us do.  Low Medi-Cal payment rates reduce the number of primary care physicians willing to see Medi-Cal patients. 

There are ways to address ER overcrowding and avoidable ER visits, such as increased after-hours offices, accessible urgent care facilities, 24 hour nurse advice lines in numerous languages, and aggressive health education and prevention efforts.  Such approaches are not only consumer-friendly, they are also cost-effective.

With one million members in Los Angeles County alone, L.A. Care is the largest Medicaid health plan in the nation.

Click here to read the Los Angeles Times article.

Click here to read the full study.