Wednesday, July 27, 2016

This year we are celebrating an important milestone in California: it’s the 50th anniversary of California’s participation in Medicaid (or Medi-Cal, as it is known in our state), which has helped bring health coverage to millions of families with low incomes – allowing access to health care that would be out of reach otherwise. 

Medi-Cal is a safety net program in the truest sense of the word: it covers health care for over 13 million Californians from nearly all walks of life, helping people to weather the transition through adverse life events that might otherwise leave them uninsured, bankrupt, or worse. We at L.A. Care Health Plan are proud to serve our community by coordinating care for over 2 million people in L.A. County who rely on Medi-Cal for coverage. 

But Medi-Cal is more than a backstop against financial loss – it is a smart investment that keeps our communities healthy and productive. Healthy children covered through Medi-Cal means moms and dads take fewer days off work to care for them when sick. Working adults with low incomes covered through this program have fewer sick days, and fewer days when they show up to work but perform at a lower level because they are “toughing out” an illness. 

Medi-Cal is also a vital linchpin in L.A. County – and we have been proud of the role we have played for the last 19 years in coordinating care and maximizing the resources entrusted to us so as to deliver the best care possible for those whom we serve. 

Every day, we at L.A. Care come to work thinking about ways to better serve our more than 2 million members. And I am proud of our successes in doing so. We have taken steps that some might consider outside the normal boundaries of health care to improve lives and maximize our limited Medi-Cal resources. Here is a snapshot highlighting some of those efforts:

  • Health information technology: On this exciting and evolving frontier, our HITEC-LA program has helped 3,000 primary care providers reach meaningful use with electronic health records (EHR) and continues to assist over 2,100 Medi-Cal providers and 27 health centers with later stages of meaningful use and quality improvement. In addition, our eManagement program is improving care coordination by enhancing collaboration between primary care providers and mental health specialists. Furthermore, our eConnect program is enhancing care transition and operational efficiency by automating hospital admit, discharge, and transfer notifications and accessing hospital EHRs for patient lookup.
  • Homelessness: The homelessness rate in L.A. County has reached an all-time high. This means that helping our chronically homeless members improve their health requires looking beyond a doctor’s visit to consider housing and social needs. As such, we have funded the Corporation for Supportive Housing’s 10th Decile project to provide in-person case management, temporary housing and navigation into permanent supportive housing. And more recently, we awarded a grant to Brilliant Corners, a nonprofit that partners with L.A. County’s Housing for Health program, to help homeless individuals move into permanent housing equipped with basic necessities.
  • Nurse case manager pipeline: It is widely known that there is a registered nurse (RN) shortage – and an even greater shortage of RNs with case management experience. This is particularly challenging for managed care organizations like ours because RN case managers play a key role in implementing the new, patient-centric care delivery model set forth by the Affordable Care Act. So this January, we launched the L.A. Care Nurse Academy in partnership with Mount St. Mary’s University (MSMU) in Los Angeles to establish an ongoing nursing pipeline. Through this program, we are able to participate in the development of the managed care track in MSMU’s nursing curriculum. One of our primary goals, of course, will be to place these students into new hire roles upon graduation.
  • Family Resource Centers: Whole person care is not something we just talk about – it is something we do. In fact, we embraced this approach when we opened our first Family Resource Center in 2007. These centers, which are open and free to L.A. Care members and the general public, are neighborhood centers for health and wellness. They provide a wide range of services and resources, including behavioral health workshops, exercise classes, healthy cooking demonstrations and health screenings. Today, we have four Family Resource Centers located across L.A. County – and we are planning to open three new centers in 2017.

There is no question we are proud of the role we play in helping to keep our communities healthy and vibrant. At the same time, we will also work to do the same for the Medi-Cal program itself: our members need coverage they can count on. Accordingly, we are advocating with lawmakers in Washington and Sacramento to keep the safety net strong, and to make adjustments to the system, such as through provisions for 12-month continuous eligibility for Medicaid. 

L.A. Care will continue to work to assure that our members receive the best possible care. We will achieve that through innovation, through finding ways to maximize our limited resources, or through old-fashioned elbow grease. 

By John Baackes, CEO of L.A. Care Health Plan