How California Hopes to Halt the Revolving Door to the ER

The state budget that kicked in last month devotes more than $100 billion to Medi-Cal, California’s health system for the poor. The bulk of that money will be spent on a tiny fraction of patients. And although they’re in need of help, they’re not the sickest people.

Officials are trying to change this super-user pattern—identified in a 2015 report that still reflects state and even national trends—with an ambitious intervention.

Some super-users have life-threatening illnesses, such as children with rare cancers or people receiving major organ transplants. But most of them struggle with addiction or mental health problems and rack up high numbers of emergency-room visits and hospital admissions. So in late 2016, the state launched a five-year, $3 billion effort to identify and treat them, coordinate their care and direct them to recovery and prevention programs. (read more)