Citing severe shortcomings in the Sacramento region's threadbare safety net, a broad nexus of area leaders on Thursday committed to strengthening the community's health system by 2014, when the federal health care overhaul is scheduled to debut.
With the overhaul will come a virtual tsunami of newly insured patients – estimated at 225,000 – whose needs will have to be met by community clinics or other providers.
Virtually all speakers at Thursday's Sacramento Region Health Care Partnership agreed that time is running out for the scope of change that's needed to ramp up for 2014.
"I hope that going forward, we would be impatient and urgent and looking for outcomes, not more rhetoric," said Dr. Kenneth Kizer, director of the Institute for Population Health Improvement at UC Davis Health System.
Research by the health care partnership, an initiative of Sierra Health Foundation, found that 40 percent of patients discharged from emergency departments in 2010 had gone there with non-emergency health problems.
Over a five-year period ending in 2010, usage of emergency departments in the four-county region of Sacramento, El Dorado, Placer and Yolo grew 24.5 percent, compared with average growth of 13.3 percent statewide.
The reasons that people – both those covered by Medi-Cal (California's version of Medicaid) and self-pay – are drawn to emergency rooms for care are myriad, but may boil down to the ease with which emergency rooms can be found.
By the same token, it's become increasingly difficult to find private primary care doctors willing to treat patients at Medi-Cal rates.
Health clinics and other providers in the Sacramento region need to do a better job of increasing staffing and capacity, and making themselves known to the community, experts said.
Rep. Doris Matsui, D-Sacramento, urged the gathering to take swift action on a series of recommendations made by the Health Care Partnership.
"We have less than 18 months, so there really is a sense of urgency driving our actions," the congresswoman said. "If we fail to prepare, we'd be letting the public down. This is not a risk we can take."
To help keep the initiative moving forward, the Sierra Health Foundation pledged $3 million toward making the recommendations reality.
Among the most poignant of the foundation's findings was that half of the regions 37 community health centers were operating in the red, mainly because of lack of patient revenue.
The Affordable Care Act could help reverse this trend if community health centers are prepared to meet the demand of newly insured patients, about 60 percent of which are projected to be covered by Medi-Cal by 2016. Unlike many private primary-care physicians, the clinics will accept Medi-Cal payments.