California / IN BRIEF : SANTA ANA : Supervisors OK New Health Care System

Orange County supervisors formally set in motion a new health care system that is expected to change how thousands of low-income residents receive medical services. Supervisors unanimously approved a seven-member board of directors to govern what is expected to be the state’s largest public health maintenance organization, which would provide care for at least 250,000 Medi-Cal patients. Known as OPTIMA, the system depends largely on attracting physicians by offering a more efficient means of reimbursement than Medi-Cal. “Local physicians believe that OPTIMA is the best chance in several years to improve the delivery of health care to our indigent patients,” said Dr. Melvyn L. Sterling, president of the Orange County Medical Assn. It “will take patients out of emergency rooms and into physician offices and other settings where primary and preventive care will be rendered.” Officials in Santa Barbara and San Mateo counties, which have smaller HMOs, said they have reduced use of emergency rooms by Medi-Cal recipients by more than half because illnesses are treated early. State and county officials say the advantage to doctors is prompt reimbursement. The Medi-Cal process has long been criticized by physicians who say the paperwork is overwhelming. Payment can take up to six months and often represents as little as 20% of the cost of the medical care, they say. OPTIMA will pay a flat monthly fee to doctors for every patient treated. The amount has yet to be determined. In 1983, Monterey County established the first county-organized health system for Medi-Cal patients. But it went soon broke because of poor management, state officials said.