Greene: CalOptima Health’s Decision to Eliminate Safety-Net Hospitals Harms Vulnerable Patients

Hospitals throughout Southern California are reporting extremely high patient volumes – even higher than during the pandemic. Many hospitals are functioning at or beyond normal capacity

In this situation, and in fact at all times, it is imperative that health plans meet their state-imposed obligation to support the ability of their members to obtain the care they need. By excluding hospitals from their network, the burden of care shifts to remaining hospitals at a time when they are already challenged with limited emergency department and inpatient bed capacity.

In Orange County, CalOptima Health, the County Organized Health System created to operate the Medi-Cal managed care program that serves more than one in four Orange County residents, has eliminated four key safety-net hospitals from its network, effective February 5. This decision means up to 940,000 residents have fewer options for the care they deserve resulting in a devastating impact on the thousands of vulnerable and underserved CalOptima members that rely upon these hospitals.

Limiting the access of Medi-Cal enrollees to care providers and hospitals creates dangerous barriers to emergency and acute care that can lead to harmful delays to medical care, which negatively impacts health outcomes (including medical, psychological, and functional abilities).

This decision will have a disproportionate impact on communities who get their care at these four hospitals: West Anaheim Medical Center, Garden Grove Hospital Medical Center, La Palma Intercommunity Hospital and Huntington Beach Hospital. However, hospitals in neighboring communities will undoubtedly be impacted as well as more people seeking care in already overcrowded emergency departments. The ripple effect caused by CalOptima Health’s actions will place an immense burden on the overall health care system, leading to longer wait times for critical medical services, potentially compromising patient outcomes, and adding stress to an already strained health care workforce on the heels of an intent to close emergency department services by another Orange County hospital. 

A significant number of these concerns were articulated by the affected patients and their physicians during the most recent Orange County Board of Supervisors meeting. More than 300 residents have signed an online petition urging CalOptima Health to reconsider its harmful decision.

One concerned patient shared, “I have been to Garden Grove Hospital many times before. I need to be able to come back because I am unhoused. I have received great treatment here. My 90-year-old grandparents come to Garden Grove Hospital too. It would be very hard for me and for them without CalOptima Health at Garden Grove Hospital”.

There is no question that this concern weighs heavily on the minds of Orange County’s most vulnerable patients, leaving them sleepless at night, fearing whether they will be able to access the care they require, precisely when and where they need it.

Many of the unhoused and low-income residents who rely on care at these facilities experience barriers to adequate transportation and are being asked to travel outside of their communities to have one of their most fundamental needs met. Additionally, the impact on the county emergency management system will also be significant, as CalOptima Health patients seeking emergency treatment at these hospitals who need to be admitted will have to be transported to other in-network hospitals, increasing ambulance wait times and delaying care for patients. This situation is further compounded by the fact that two of Orange County’s three trauma hospitals are situated within a mere 7 miles of the soon-to-be-terminated hospitals.

We firmly stand in solidarity with the hundreds of patients and physicians who have courageously voiced the concerns outlined above. For the residents of Orange County, this decision significantly heightens the risk of adverse outcomes, potential avoidance of necessary care, delays that might lead to permanent impairment, or worse – death.

We urge CalOptima Health to live up to its mission of serving member health with excellence and dignity, respecting the value and needs of each person, and, most importantly, to persist in expanding care options rather than further constraining them. It is a critical time for us to come together as a community and safeguard the accessibility of vital health care services for those who depend on them the most.

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