Serving the needs of some of California's most high-need low-income patients — those who frequently use emergency rooms for care and are affected by multiple chronic conditions, severe mental illness, substance abuse issues, homelessness or recent incarceration — can prove difficult even during the best of times. But the COVID-19 crisis presented an entirely new set of hurdles.
A new study by the UCLA Center for Health Policy Research examines how the state's Whole Person Care program, a pilot project launched in 2016 to integrate medical care, mental health services and social supports like housing aid for Medi-Cal beneficiaries from these vulnerable populations, responded to the pandemic's challenges. In many cases, the findings show, Whole Person Care's 25 county-based pilot programs were able to successfully pivot in order to continue providing health and social services and enroll participants.
Despite obstacles like lockdowns, staff shortages and hiring freezes, the majority of programs provided a steady level of primary and specialty care to enrollees throughout 2020, in large part by organizing telehealth visits — a significant undertaking given the limited access to smartphones or computers among large segments of the enrollee population. At the same time, emergency room visits and hospitalizations showed a significant decline, and enrollment in the program jumped by 25%, said Nadereh Pourat, lead author of the study and associate director of the research center.
These and other detailed findings from the study provide a roadmap for Medi-Cal as it moves to expand these pilots' innovative coordinated care approach to all eligible Medi-Cal members throughout the state as part of CalAIM, or California Advancing and Innovating Medicare, the insurance provider's comprehensive overhaul, which launched on Jan. 1, Pourat said.
"The findings show the value of Whole Person Care's infrastructure and demonstrate that the program serves as an effective model for future Medi-Cal programs," she said.
