title: Transforming a traditional safety net into a coordinated care system: lessons from healthy San Francisco.
abstract: Since 2007, San Francisco, California, has transformed its traditional safety-net health care "system"-in reality, an amalgam of a public hospital, private nonprofit hospitals, public and private clinics, and community health centers-into a comprehensive health care program called Healthy San Francisco. The experience offers lessons in how other local safety-net systems can prepare for profound changes under health reform. By July 2010, 53,546 adults had enrolled (70-89 percent of uninsured adults in San Francisco), and satisfaction is high (94 percent). Unnecessary emergency department visits were less common among enrollees (7.9 percent) than among Medicaid managed care recipients (15 percent). These findings indicate that other safety-net systems would do well to invest in information technology, establish primary care homes, increase coordination of care, and improve customer service as provisions of the national health care reform law phase in.
authors.affiliation: Health Services for County of Los Angeles, CA, USA. mkatz@dhs.lacounty.gov
authors.forename: Mitchell H
authors.initials: MH
authors.lastname: Katz
authors.forename: Tangerine M
authors.initials: TM
authors.lastname: Brigham
mesh_terms: D000328:Adult; D000368:Aged; D003256:Community Participation / Q000523:psychology / Q000706:statistics & numerical data; D018166:Health Care Reform; D006297:Health Services Accessibility / Q000458:organization & administration*; D006300:Health Services Misuse / Q000706:statistics & numerical data; D006801:Humans; D008329:Managed Care Programs / Q000706:statistics & numerical data; D017057:Medically Uninsured / Q000145:classification; D008875:Middle Aged; D017146:Models, Organizational; D009936:Organizational Innovation; D010358:Patient Participation; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D015397:Program Evaluation; D017751:Safety Management / Q000379:methods*; D012495:San Francisco; D013221:State Health Plans; D017216:Telemedicine