By 2010, Healthy Way LA was fully operational and merged with the PPP program. Both new enrollees into the program and existing participants who were enrolled in HWLA were able to gain access to inpatient, emergency and urgent care services within Health Services and outpatient services at the Community Partner Medical Home. Patients were eligible for HWLA if they did not have health insurance, were a Los Angeles County resident, had a monthly household income at or below the 133% Federal Poverty Level, not pregnant at the time of enrollment, and not eligible for Medi-Cal or Healthy Families.
Although initial enrollment fell short of the initial three-year program target of 94,000 (2007-2009), participant enrollment ballooned to impressive numbers after the Affordable Care Act was signed into law. From 2010 to 2011, approximately 80,000 patients from the LA County Department of Health Services and Public-Private Partnership were enrolled into Healthy Way LA. By the end of 2012 the number of enrolled participants had swelled to over 200,000, with over 650,000 primary care visits logged for HWLA members. The number of enrolled participants continued to increase over the next few years. By the time PPACA had gone into effect in 2014, HWLA had about 300,000 participants.
HWLA patient enrollees were broadly categorized into two groups as part of a “bridge to reform” arrangement. The first of these two groups, or “prongs,” was classified as Healthy Way LA Matched and consisted of enrollees who met all the program requirements and were either U.S. citizens or legal residents. For each of these enrollees, the HWLA program received 50 cents on the dollar in federal funding. Those in the Matched group were transitioned into Full-Scope Medi-Cal on January 1, 2014.
The second prong, Unmatched, consisted of participant enrollees who did not qualify for the bridge to reform and largely came from the former Public-Private Partnership program. Funding for this group was not matched by federal funding but received county funding by LA County Board of Supervisors to reimburse community clinic partners for care in a capitated payment model. At the conclusion of the HWLA program, these participants who did not transition to Full-Scope Medi-Cal and who remained residually uninsured were rolled over into the My Health LA program.
