OPTIMA to Preserve ‘Net’ of Doctors Known to Aid Poor : Hearing: Providers will be forced to change under county’s new Medi-Cal health care delivery system, chairman warns. Access is still the top priority.

Preserving the “safety net” of physicians, community clinics and hospitals that long have served the poor should be a high priority, everyone agreed at a hearing Tuesday to discuss a new health care delivery system for Orange County Medi-Cal recipients.

However, the board of directors of OPTIMA, the agency that will develop a countywide Medi-Cal managed care system, warned that these traditional health care providers will have to make changes, such as forming full-service networks or joining existing health maintenance organizations, to survive.

“Changes are going to have to take place. We are not going to have the status quo. I think that is the message,” OPTIMA Chairman John R. Cochran said at the hearing to obtain public reaction to options for designing the new health program.

At the start of the three-hour hearing, Westminster Councilman Tony Lam presented a petition signed by 4,500 Vietnamese residents asking that they retain the right to choose their physicians, hospitals, pharmacies and other services and “not have to follow a bureaucratic and complex health care system.”

Dr. Hung Ong, speaking for the Vietnamese Medical Assn. and the Vietnamese Physician Assn. of California, said there are 40,000 Vietnamese on Medi-Cal in the county already receiving adequate treatment from Vietnamese physicians who “faithfully cared for them through years of decreasing reimbursements and increasing bureaucracy and continued to stand by them even when the state was paying with IOUs that no bank honored.”

Ong said such physicians have “earned the right to be preserved as a special provider category, part of the health care safety net.”

Cyndy Johnson, managing director of the Pacific Health Care Policy Group who is serving as a consultant to the OPTIMA board, said that an astoundingly large number of people eligible for Medi-Cal in Orange County, many of them children, are not getting medical attention.

“Less than half of those eligible for Medi-Cal (in Orange County) use the services,” she said. By contrast, she said, 88% of those eligible for Medicaid in New York get medical care.

The purpose of OPTIMA, she noted, is to improve access to health care for Orange County residents dependent on the state program whose low reimbursement rates have historically discouraged physicians from participating.

Johnson cautioned that even under a proposed new system in Orange County that would pay primary physicians a monthly fee for each patient, medical services will be limited by Medi-Cal’s severe budget constraints.

“We have a very poorly funded Medicaid system in the county and the state, the likes of which I have seen only in the very deep South,” Johnson said. “There is no pot of gold at the end of this rainbow.”

But the dollars can be stretched, she said, through a system that will shift more care away from hospitals and hospital emergency rooms and toward primary care physicians.