California’s health program successfully reduced hospital visits

SACRAMENTO, California. – A five-year experiment to improve care for some of California’s most vulnerable Medicaid patients — including homeless people and those with severe drug addictions — resulted in fewer hospitalizations and emergency room visits, saving taxpayers an estimated $383 per patient per year. according to a review published on Wednesday.

The UCLA Center for Health Policy Research said that for every 1,000 people enrolled in California’s Whole Person Care pilot program, there were 45 fewer hospitalizations and 130 fewer emergency room visits than a similar group of patients not enrolled in the program.

California has the largest Medicaid program in the country, with approximately 13 million people receiving free health care from the government. That’s about a third of the state’s population.

In 2016, the state launched an experiment that focused on the most vulnerable Medicaid patients, those prone to expensive, repeat hospital visits but whose condition rarely improved. These included people who were homeless or at risk of homelessness, people recently released from prison, people with multiple chronic health conditions, and patients with severe drug addiction or mental health problems.

These programs not only focused on a person’s medical care, but also on things like transportation, education, legal assistance, and help in finding and keeping a job. The program didn’t pay for people’s housing, but it did pay for things that helped them find housing — including money to cover security deposits, the first month’s rent, furniture and moving expenses.

Sacramento Covered, a nonprofit that connects people to social services in the California capital, has partnered with the local housing authority to help people find housing. Group CEO Kelly Bennett said it’s often difficult to find an apartment in a competitive rental market, but having money to cover a security deposit increases the likelihood of success.

Beyond housing assistance, Bennett said people get most of the help from community health workers, who can guide patients through “all these different systems that are isolated and challenging in the best of circumstances.”

“Community Health Workers are really brokers of service and sort of grease the wheels on behalf of their clients,” she said.

Different groups had very different results. The program was far better at reducing emergency room visits and hospitalizations for people who were homeless, addicted to drugs, or with serious mental health problems than it was for patients with complex medical problems. However, the program was better at reducing overall costs for people with complex medical problems, saving an average of $511 per patient per year.

“The results show that such programs help complex patients in different ways depending on their needs,” said Nadereh Pourat, associate director of the UCLA Center for Health Policy Research. “Most importantly, our findings underscore the overall success of the Whole Person Care program and its potential to improve the lives of high-risk patients.”

Overall, the program cost $3.6 billion and included 25 pilot programs in 26 counties, serving nearly 250,000 patients – 70% of whom suffered from serious mental illness, drug addiction or homelessness.

The pilot programs ended in December 2021. But California is already expanding services statewide, part of a larger overhaul of the state’s Medicaid program known as CalAIM — or California Advancing and Innovating Medi-Cal.