Los Angeles Rolls Out Complex Care Teams for Chronically Ill Patients

Los Angeles County’s Department of Health Services is betting it can save money while radically improving the health of some of its sickest and most challenging patients. Last March, county health officials began targeting individuals in South and East Los Angeles who rely on emergency departments or hospitalizations for care and who struggle with more than one chronic disease.

“They suffer from the whole gamut of issues,” said Clemens Hong, a family physician who is medical director of the pilot program, Care Connections, which aims to reach about a thousand patients. Many of them struggle with mental illness, addiction, homelessness, poverty, and a history of childhood trauma, Hong said.

“If we can do it in this group, we can do it anywhere,” Hong said, adding that LA County’s patients are arguably sicker as a group than they are anywhere else in the state.

In recent years, counties, insurers and health care providers are increasingly investing in the least healthy in their populations with an eye on the bottom line, even as the jury is still out on whether and how much most such programs save in healthcare costs.

“Taking care of high-risk, high-cost patients is important for one very clear reason,” said Marci Nielsen, who heads the Washington D.C. based Patient-Centered Primary Care Collaborative, which advocates for primary care. “That’s where there are savings to be achieved.”