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The Medi-Cal Model Essay

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Literatures have shown that the Medi-Cal program is associated with frequent hospital admissions and heavy reliance on the emergency department (ED) in comparison to commercially insured patients (McConville & Lee, 2008). The situation could be deteriorated after the rollout of Affordable Care Act (ACA). A recent report shows that the ED rate increased from 572 to 651 visits per 1000 enrollees from 2005 to 2010. This is four times higher than the privately insured, and 2.5 times higher than the uninsured. In addition, Medicaid patients consistently had the highest rate of visits for potentially preventable conditions (Hsia, Brownell, Wilson, Gordon, & Baker, 2013). Naturally, it is expected to be higher in a disabled population. Today our result shows that safety-net clinics operating under a PCMH model avoided ED use by 30% to 50% dependent on members having at least one office visit per year. Such an encouraging news indicates that the PCMH model can be an effective strategy to reduce ED use, particularly for the frequent ED users. The PCMH model has been shown some …show more content…

We accomplished this through interviews with clinic leaders. The purposes of these interviews were twofold: Firstly, to evaluate the plausibility of our findings and secondly to understand the key differences between the PCMH and non-PCMH clinics in regards to the availability of the PCMH attributes. Among all the responses, “access to care” was most frequently cited by experts. By operating with extended office hours, including weekends, and a helpline available to their patients, the PCMH clinics offer accessibility to those who would otherwise not have access to care. A good example is people with disabilities for whom they usually need assistance from family members or friends to commute or travel. Visiting doctors, as a result, might depend on the availability from people who can help

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