405,348. That’s the number of people in the San Fernando Valley and the Santa Clarita Valley who are uninsured. But while the number may be astounding to some, it hardly reflects the number of people who will be affected by the Supreme Court’s impending decision on whether to uphold or strike down the individual mandate of the Accountable Care Act. That number is much, much larger, regardless of the final decision. Valley Care Community Consortium, a nonprofit that tracks a plethora of health-related issues, estimates that the uninsured represent 20 percent of the Valley’s population. The figures do not surprise people like Judi Rose, vice president and chief development officer at Valley Community Clinic, which treats roughly 19,000 patients a year, the vast majority of them uninsured. Nor are the disparities from one Valley community to the next surprising to her. In wealthy Agoura Hills and West Hills, the uninsured account for less than 6 percent of the population. In the clinic’s neighborhood in North Hollywood, the figure stands at 24.5 percent, the Valley’s highest, with 41,859 uninsured. The numbers come from the San Fernando Valley/ Santa Clarita Valley Triennial Community Needs Assessment report compiled every three years by the consortium, which is made up of dozens of health care provider organizations, businesses, government agencies and elected officials. The consortium’s incredibly detailed work — chronicling the Valley’s needs — serves as a good reminder of why the issues being debated by the Supreme Court justices are so critical back home. It’s not that the uninsured don’t have health care. It’s that the care they receive tends to be haphazard, ill-timed and much more costly than it needs to be. Everyone knows that a flu vaccine from a primary care doctor is more effective and less expensive than a visit to the emergency room for the flu. But the uninsured too often wind up in the emergency room, where they drain resources and indirectly cost taxpayers and businesses anyway as hospitals pass the charity or indigent cost of care on to government or private health insurers. The state of California, as well as several health care organizations in the San Fernando Valley, have made significant progress in the two years since the reform law was passed. In fact, many say there’s been too much progress to turn back the clock on reform. At the Valley Community Clinic, for example, many of the uninsured are now in the process of being enrolled in a program that makes the clinic their medical home. New mothers come with their newborns to receive free childhood vaccines and baby checks. School children get their teeth cleaned for the price of a hamburger; women come for their annual mammograms. If the Accountable Care Act survives, most of these people who are now uninsured, will come under Medicaid in 2014. In the meantime, they have found good place for preventative care which will keep them healthier and cost businesses and taxpayers less in the long run — if the act survives. But clinics are not the only beneficiary of the new law. In the last two years, hospitals and doctors around the Valley have been working at a feverish pace to figure out how to make the new law work for them. They have installed electronic medical record systems to keep better track of patient care and to avoid unnecessary or repetitive visits and procedures. They have formed alliances to offer a continuum of coordinated care. They are forming accountable care organizations and finding ways to deliver better care for less money. Organizations such as Providence Partners for Health have been created, pulling together doctors and hospitals to figure out how to deliver more coordinated, less costly care. Health insurance companies like Health Net Inc. and Anthem Blue Cross have introduced innovative plans that reduce the cost of insurance to small and medium sized businesses. And Northridge-based Heritage Provider Network is funding a $3 million prize for the innovative person who can develop the algorithm that will be able to predict and prevent unnecessary hospitalizations, a $30 billion problem in this country. The Affordable Care Act has its pros and cons, and its backers and vocal naysayers. But regardless of the politics, it can’t be denied that the Act has unleashed much that’s good and innovative in California and here in the San Fernando Valley. It has energized people to think out of the box about how we can deliver better care to more people with less money. Joni Novosel, executive director of the consortium, estimates that if the law survives, 80 percent of the 405,348 uninsured Valley residents will have health insurance. The individual mandate is key to making it all work, Novosel said. But even if the mandate is struck down by the Court and other parts of the law survive, there still will be benefits, she said. For example, she hopes the provision that makes insurance more affordable for small businesses will remain intact. Why? Most businesses in the Valley are small businesses — and as things are, most are unable to afford health insurance. Thus the number 405,348. “I’m a little nervous,” she said, “But I hope at least small business will be able to offer access to health insurance.” Staff Reporter Judy Temes can be reached at (818) 316-3124 or at [email protected].
Providers Wait For Final Word on Health Care Reform
