NYAPRS Note: As NY moves quickly toward a public health redesign at every system level—from Medicaid expansion, to adult and nursing home community transition, to managed behavioral healthcare and DSRIP—advocates to continue to press state leaders and payers on the issue highlighted in the article below. Safety net providers and other caregivers for persons with the most complex or chronically unmet needs cannot redesign their own provider systems without additional help and attention from the state. If payment systems realign through managed care companies but do not add additional revenue, training, or infrastructure, many providers will have to scramble to meet new administrative demands—like collecting and reporting data, and billing to multiple payers—while meeting the needs of at least as many consumers as they were previously. NY has budgeted some money to help with transitional costs, but in the face of so much change, many of us are wondering how small clinics and community providers will adequately prepare for the transformation.
Only 2 in 5 L.A. Health Clinics are Ready for Obamacare Patients
LATimes; SOUMYA KARLAMANGLA, 5/22/2014
Just 2 in 5 Los Angeles community health clinics are ready for the impacts of Obamacare, a new study found.
A May brief from the UCLA Center for Health Policy Research examined approximately 40 clinics in the Los Angeles area to determine how prepared they were for an expected increase in new patients because of the Affordable Care Act, the national healthcare law that went into full effect this year.
Historically used by low-income patients with few options, community health clinics have begun employing a variety of strategies to make themselves more attractive to patients with new insurance plans and choices.
Under Obamacare, hundreds of thousands of people signed up for health insurance in Los Angeles County. The county led the state in sign-ups through Covered California, with more than 400,000 enrolling. Hundreds of thousands more signed up for Medi-Cal, the state’s health plan for low-income residents.
Now, the clinics are expected to not only serve newly insured patients, but also to continue to care for those who still don’t have health insurance. It’s estimated that 1 million people in Los Angeles County will remain uninsured.
“More people than ever before now depend on community health centers for essential healthcare,” said Nadereh Pourat, a UCLA professor of health services who led the study.
The researchers scored the clinics in four categories — the implementation of new technology, like electronic health records; increasing their managed-care participation; improving the quality of their services; and moving toward a “medical home” model of care.
Based on these measures, they found that 39% of the clinics were ready for Obamacare, and that 62% were in some stage of readiness. However, many — especially smaller clinics — lacked the resources to prepare for the expected influx of patients.
This is particularly important because L.A. County officials say they’re going to assign about 100,000 of the remaining uninsured to community health clinics under a managed-care-type system in the fall of this year.
The clinics “need support to expand beyond their traditional roles and responsibilities if they are going to effectively serve new populations,” Pourat said.