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Specialty Care List of High-Risk Current & Former Participants

Specialty Care List of High-Risk Current & Former Participants

By: Jorrel Sampana, MHLA

Specialty Care List of High-Risk Current & Former Participants

Specialty Care List of High-Risk Current & Former Participants 1024 576 My Health LA

Recently, the MHLA program office has distributed to Community Partners lists of individuals who are 50 years and older who were in MHLA at some point within the previous six months and saw a specialist at DHS during that time. Please note that some of these individuals have already transitioned to Full-Scope Medi-Cal and have been disenrolled from MHLA, with others being disenrolled on July 31, 2022. All the individuals on this list have been identified as high-risk by our DHS specialty care team.

The purpose of this list is to assist our Community Partners with communicating with and providing guidance, as needed, to these patients in need of extra care and linkage. MHLA hopes that the list will also assist you all with determining the best possible path forward for long-term and short-term specialty care for these patients given their health issues and eligibility for/transition to Full-Scope Medi-Cal. Los Angeles County Health Services and MHLA are not providing or advising a specific course of action, but rather aim to ensure that these patients do not fall out of care while transitioning to their new health plans.

Additionally, we received a few requests for a legend for the column headers in the Excel spreadsheets sent to each CP. Please see this breakdown of the headers that may help in sorting through your lists:

  • Demographics
    • MRN (Medical Record Number)
    • Name
    • Contact info (both from MHLA and DHS databases)
    • Medical Home/Agency
  • High risk categories
    • # Outpt SC Visits (past 6 mos) = Outpatient Specialty Care Visits within past 6 mos
    • Past SC Visit List (past 6 mos) = Past Specialty Care Visits over the past 6 mos
    • Future 3  mo Appt List (Location, date and appt type) = Future Appointment List for the next 3 mos
    • # Infusion Appts
    • # Inpt Stays = Inpatient Stays
    • # Inpt to SC Orders = Inpatient to Specialty Care Orders (indicates patient followed up in SC after hospital discharge)
    • # ED Visits = Emergency Department Visits
    • High Risk Meds & Med Names

We hope this helps. You can also review the MHLA Provider Bulletin that provides information and guidance on this population and DHS’ plan for these high-risk patients during their transition to Full-Scope Medi-Cal.