The ranks of Medi-Cal recipients are growing by 10,000 a month in Sacramento County because of the Affordable Care Act, WellSpace Health CEO Jonathan Porteus told me, and his Sacramento-based nonprofit is expanding around the region with primary-care clinics to serve patients.
The federal designation allows WellSpace at a higher Medi-Cal rate than other providers.
“We’re able to survive some of the cutbacks in Medi-Cal that the primary care doctors who are private couldn’t,” Porteus said. “That’s why you see a lot of Medi-Cal doctors leaving this business.”
WellSpace also is growing because giant hospital companies see the value in partnering with it, Porteus said. In October 2012, as part of the Affordable Care Act, hospitals became financially responsible if they readmitted a patient for the same condition within 30 days of prior treatment, he said. To avoid this burden, Porteus said, hospitals are helping to establish a network of primary care physicians for uninsured or low-income patients.
Porteus gives local hospital groups credit for working with WellSpace before the Affordable Care mandate. For example, WellSpace started a program called T3 (Triage, Transport, Treat) in Sutter Medical Center’s emergency department. In the ER, medical staff identified patients who needed primary, not urgent, care, and they directed them to WellSpace centers. Among that T3 population, Porteus said, WellSpace has gotten 65 percent of patients to seek out WellSpace instead of an emergency room, and the incidence of hospitalizations declined by 25 to 30 percent.
Determined to expand upon these accomplishments, Porteus is opening or expanding other sites around the region. Next month, WellSpace will open San Juan Community Health Center near Dignity’s Mercy San Juan in Citrus Heights. He hopes to gain federal funding to expand the Tom Gagan Community Health Center, 631 H St., to full-time hours within a couple months. Over the next 12 months, he’ll also grow operations in Folsom and midtown Sacramento. And, as my colleague Loretta Kalb reported Friday, WellSpace will open a health center at Hiram Johnson High School by January, and Porteus has designs on space at other schools.
While a great deal of the funding for WellSpace’s services come from Medi-Cal or Medicare, Porteus said he has woven together funding from such disparate sources as federal economic stimulus grants, county and state monies and contributions from hospital companies. It’s his goal to create a blanket of care, rather than a safety net, to cover underserved residents.