St. John Health Care Net: A Network Approach to Providing a Health Care System for the Uninsured

In concert with its mission of “Health Care That Leaves No One Behind”, St. John Health, Department of Community Health has developed a network of health care services for the uninsured. The program is designed to support uninsured patients discharged from a health system hospital or emergency department by enrolling them in the Care Net, assigning them a medical home, and scheduling them an appointment within five days of discharge.

St. John Health supports the Care Net's two primary care clinics by providing funding for the clinics, laboratory services, imaging services, and hospital care for participating patients. Specialty care is through the “Physicians Who Care” network of volunteer specialty physicians, an internal medicine specialty consultation clinic, a urology clinic, and an endocrinology clinic.

Pharmaceuticals are subject to a strict formulary and are available through our “340B” qualified pharmacies for an administrative cost of $5.00 for a ninety-day supply. Brand medications are sought through the myriad of free programs offered by the pharmaceutical companies.

A referral process similar to that used by most HMOs controls utilization. In this program, the medical director, using criteria approved by the medical advisory board, screens all referrals for imaging, specialty, and hospital care.

Pre-program and post-program enrollment claims data suggests that overall cost of health care for participants is significantly reduced.