L.A. County free clinic system to use medical-home model

Los Angeles County is expanding and overhauling its free health program for low-income, uninsured residents. It's one of very few in the U.S. that extends healthcare to residents living in the U.S. illegally and thus don't qualify for the coverage options under the healthcare reform law.

To reduce episodic use of the system, participants will now be required to exclusively use one clinic for all of their primary-care needs under a medical-home model. Under My Health L.A., the county will now pay clinics a monthly fee of $32 per patient. In the past, uninsured county residents could get care at a network of over 160 community clinics, and the county would pay the clinics a per-service fee.

Anyone living in the county who makes less than 138% of the federal poverty level and can't get insurance or enroll in Medicaid can sign up for the program. Participants can get hospital and emergency care at hospitals operated by the L.A. County Department of Health Services.

Tangerine Brigham, deputy director of managed-care services for the department, said she and her team want to create a system in which patients will have a consistent source of primary care—a specific physician or team that would know the patient's history and be equipped to administer preventive services to keep the patients out of hospital emergency rooms.