Look around the region, and you'll see that Molina Medical is expanding almost everywhere: doubling the size of its Norwood Avenue location, opening a new clinic this summer on Mack Road and hunting for larger space in Citrus Heights.

While cuts to Medi-Cal are threatening some hospitals' ability to remain open, this managed-care company is actually benefiting from efforts to reduce costs in public welfare programs. Seniors, the disabled and other individuals with low incomes are being shifted into HMOs as government tries to control costs with preventive care.

"This is a good problem to have, but we've run out of space," said Gloria Calderon, vice president of clinic operations for Molina Medical, a for-profit based in Long Beach that serves low-income patients. "The other reason we're looking to place this new clinic on Mack Road and expand Citrus Heights is because of what's going to come down the pike with health-care reform. The eligible Medi-Cal recipients in California could actually double in 2014, so we want to be in a good position to accept new membership."

Molina has expanded its Sacramento workforce by 72 percent since 2010, and it has focused on ensuring that patients come for regular checkups.

The company runs free shuttles in neighborhoods near clinics from 8 a.m. to 5 p.m., stopping at post offices, groceries and Molina clinics at regular intervals. They are opening so-called kids corners in clinics to ensure that lack of child care isn't a barrier to people seeking medical attention. Their patient coordinators call to follow up if patients miss appointments.

All this sounds a little pricey, but Calderon takes the long view.

"We are a publicly traded company, and we do want to watch our bottom line," she said, "but at the end of the day, that good will that we receive out there from providing this service definitely gets new patients into our clinics."

Sutter targets obesity

John Hernried started practicing as a primary-care physician right around the time that fen-phen was all the rage. The diet drug later proved a cause of pulmonary hypertension and heart valve problems.

"I saw in my practice that these patients were going to clinics to get pills and coming back to me with side effects," he said. "I didn't really like what was happening, but … in my practice of internal medicine, I found that so much of what I was treating – diabetes and hypertension – was related to weight."

Hernried became really curious about obesity as a disease, so much so that he recently became one of just 226 physicians across the nation to become board-certified in obesity medicine.

"I get to take people off their diabetes medicine and off their hypertension medicine," Hernried said. "It's a lot more fun that way."

For the past five years, Hernried has been working to consolidate all the weight management programs at Sutter into one entity. In November, the Sutter Weight Management Institute was born, and Hernried is its medical director.

"It ranges from a 12-week program for patients who want to learn about weight loss … all the way up to medical weight loss programs and on up to bariatric surgery," Hernried said. "We all work together and we're required to keep outcomes. … One of the things that has been missing with bariatric surgery is that many patients have their surgery done, and for the most part, they fall off the radar."

Hernried said Sutter physicians hit the pause button on bariatric surgeries for several years, forgoing revenue until they got the institute going. The initial 12-week program costs about $150, Hernried said, but funds from a flexible spending account can be used to pay for it. Second-tier programs include regular meetings with physicians and perhaps behaviorists, exercise physiologists, nurse practitioners and dietitians. Many health plans cover it.

Hernried hopes to garner interest from employers. For every $1 spent by an employer, he said, there's as much as a $3-$4 return in terms of reducing health care costs and improving productivity.

"We talk about diabetes and hypertension, but there's also the loss of productivity, the arthritis," he said. "Certainly, the people who we know who are obese, they don't get the same pay, they don't get the same raises."

Call The Bee's Cathie Anderson, (916) 321-1193.

© Copyright The Sacramento Bee. All rights reserved.

• Read more articles by Cathie Anderson