SCAN's medical group for homeless patients grows insurer clients

SCAN Group's medical not-for-profit, specializing in care for the homeless, officially secured its first independent insurer contract, with Healthcare in Action's partnership with Molina Healthcare cementing the company's plan of leveraging local health plans and health systems as customers.

Molina Healthcare has partnered with Healthcare in Action to provide care for its homeless members and sign the unhoused up for its Medicaid plans. Molina is one of the largest Medicaid carriers in the nation with 4.1 million enrollees, and about half of the 163,000 individuals without homes in California qualify for some form of health insurance, the company says.

The company did not respond to an interview request.

The insurer represents Healthcare in Action's first health plan customer outside of Scan Health Plan, a not-for-profit insurer specializing in Medicare Advantage. As part of the deal, Molina will become a founding sponsor of the 15-person not-for-profit, which is a wholly owned subsidiary of SCAN Group.

While insurers like Aetna, UnitedHealthcare and Centene have spent the last year invested in affordable housing, SCAN Group represents the only healthcare company that has launched a street medical group dedicated specifically to caring for individuals without homes, said CEO Dr. Michael Hochman. The company's clinical teams travel to homeless encampments, shelters and hospital emergency room departments to offer primary and behavioral healthcare to individuals, regardless of what carrier, if any, they are insured under. Healthcare in Action's work focuses particularly on treating addiction and mental health conditions, he said.

"The reason these affordable housing programs haven't worked as well is because—if you don't address the mental health and the substance use and the other health issues that are interfering with people getting housed—if you build it, they won't necessarily come," Hochman said. "I've seen patients offered housing and they choose not to take it because they have uncontrolled schizophrenia or they have a substance use issue."

Since launching in January, the company has served 65 patients, which are split evenly through payers and providers.

The not-for-profit has inked partnerships with Cedars Sinai Medical Center in Los Angeles and College Medical Center in Long Beach to offer post-discharge services to patients without homes. These hospitals pay Healthcare in Action to follow homeless patients for 30 days and come up with a discharge plan, complete medication programs, provide wound care and more, Hochman said.

"They might have a homeless patient who's stuck in the hospital and can't be discharged because there's no one to follow them," he said. "There's no skilled nursing facility willing to take them. They will pay us to visit the patient."

By partnering with health plans, Healthcare in Action aims to offer a managed-care model to their members without homes and save money on costly ER visits. The not-for-profit also signs up uninsured individuals who qualify for Medicaid or Medicare to one of its contracted plans—either Molina or SCAN Health Plan at this point, although the company is in talks to partner with several other insurers. It is generally paid a flat, capitated rate for each patient it serves.

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The not-for-profit launched just in time to take advantage of increased reimbursement for services aimed at addressing housing instability and other social determinants of health offered by the state's CalAim program. While the company was started through undisclosed seed funding provided by SCAN Group, Healthcare in Action eventually aims to be a self-sustaining not-for-profit, while also relying on partnerships with insurers and health systems, Hochman said.

"There are other street programs in Los Angeles," he said. "What we're doing that's different is all these other programs have relied on philanthropic or charitable funds. What we're trying to do is to create a not-for-profit with a sustainable business model using managed-care capitation."