Private hospitals in Los Angeles County are moving quickly to partner with the 35 outpatient clinics the county plans to close by Oct. 1 to keep public hospitals open.
County supervisors last week voted to accept the proposal of a healthcare crisis task force to close 35 of 45 outpatient clinics, part of a plan to meet a projected $655 million shortfall in county health services funding.
The task force was formed to find an alternative to the proposed closing of the giant LAC-University of Southern California Medical Center and other public hospitals.
Member hospitals of the Hospital Association of Southern California will try to "link with individual clinics to keep them alive," Anthony Abbate, vice president of the HASC's Los Angeles region, told MODERN HEALTHCARE.
Hospital executives have been meeting with the supervisors' newly appointed "health services czar," Burt Margolin, a former Democratic state lawmaker, to discuss partnerships with the clinics, Abbate said. Hospitals will work with the clinics, take them over or help set them up as federally qualified health centers, which are better paid by Medicaid than community clinics, he said.
In addition, the HASC is "pushing hard in Washington" for a Medicaid waiver for a demonstration project that would pour $100 million to $300 million into restructuring the county system to focus more on outpatient care. Some of those funds would be used to pay private hospitals for their involvement with the clinics.
An effort is also under way to make more of the county's poor eligible for Medi-Cal, California's Medicaid program.
Some 75% of patients at the outpatient clinics are indigent and have no insurance, Abbate said.
Private hospitals have no choice but to try to save the public outpatient clinics. Annual visits total 1.4 million for the outpatient clinics in five county hospitals alone. Those clinics are also slated for closure.
"If just 40% (of that volume) goes into private-sector emergency departments, we've got chaos," Abbate said.
County supervisors also voted to cut up to 6,700 jobs in the Department of Health Services by Oct. 1.
Because their $11.2 billion budget includes state and federal funds that have not yet materialized, the possibility of hospital closures still looms in Los Angeles.