Uninsured Won’t Get Managed Care
- Share via
Managed care has its limits, though.
CalOPTIMA, initiated in the fall of 1995, is Orange County’s ambitious experiment with managed care for hundreds of thousands of poor, elderly and disabled residents. Still, CalOPTIMA will stick with traditional fee-for-service medicine for one group that it’s planning to add--the area’s uninsured.
The uninsured--a population estimated to be as high as 300,000 residents--have enormous, unpredictable needs for health care, say CalOPTIMA officials. About 30,000 a month receive services, often in hospital emergency rooms. They often go without regular primary care and tend to be sicker when they seek care than insured people, say officials.
So the typical flat-payment method used by managed care companies to spread the risk of caring for a diverse but set number of patients, many of whom are healthy, just doesn’t apply.
*
Barbara Marsh covers health care for The Times. She can be reached at (714) 966-7762 and at [email protected]
Sign up for Essential California
The most important California stories and recommendations in your inbox every morning.
You may occasionally receive promotional content from the Los Angeles Times.
