View Research by Author - Albert Farias

Publications

This analysis shows that pediatric hospitalization rates are low both nationally and in Los Angeles County in comparison to adult hospitalization rates, and have gradually declined since 2000. This downward trend shows the impact of changes in the health care system that increasingly emphasizes ambulatory care and prevention over inpatient care. ACSC hospitalization rates decreased in Los Angeles, for both low- and high-income groups after the CHI was implemented (February 2003) compared to before implementation. Disparities, however, remain, and more work is needed to help close the gap in access to care for low income families in Los Angeles. Los Angeles: University of Southern California. July 2009.

For 25 years, low-income, non-citizen Los Angeles County residents ineligible for Medi-Cal coverage have had access to emergency, pregnancy-related, and nursing home services through the Emergency Medi-Cal (EMC) program. With the 2003 creation of Healthy Kids, many children enrolled in EMC became eligible for more comprehensive coverage under Healthy Kids. But no formal mechanism was established to coordinate the programs, and the potential for children to be enrolled in both Healthy Kids and EMC was created. This study examines the benefits and challenges created by dual coverage and efforts made to capture state and federal funds to support Healthy Kids.

It is widely known that improving access to ambulatory care helps prevent hospitalizations for ambulatory care sensitive conditions. The Children's Health Initiative of Greater Los Angeles (CHI) formed in order to improve children's access to primary care by increasing Medi-Cal and Healthy Families enrollment. Previous reports showed the CHI reduced the overall rate of preventable hospitalizations in low-income children. This study examines if the CHI similarly reduced preventable hospitalizations for low-income children in Los Angeles County by analyzing hospitalization rates in Los Angeles for lower income compared to higher income children, and calculating hospitalization rates for ambulatory care sensitive conditions.

Presently, two options exist for covering medical services for uninsured, low income children. The first is to enroll eligible children into comprehensive insurance programs such as Los Angeles Healthy Kids, which provides coverage for children ineligible for Medi-Cal or Healthy Families with family incomes below 300% FPL. The second option is through indigent care services delivered by county-operated safety net clinics that provide care to all people regardless of their ability to pay. This study examines the impact of Healthy Kids since its inception and compares it to utilization of pediatric care visits paid for through county indigent care programs. Los Angeles: University of Southern California. November 2008.

The LA Healthy Kids coverage expansion was associated with decreases in pediatric services utilization in two county-funded programs for the uninsured. Coverage expansion may have saved over $37 million in uncompensated care for children. For public hospitals and safety net clinics, data suggests that insurance not only improves access but reconfigures where people get care. It also helps reduce uncompensated care and provides new avenues to support the healthcare safety net. These data suggest that state- or jointly-funded insurance expansions help offset the growing burden of uncompensated care among safety net providers while improving utilization and child health status. Journal of Public Health Management Practice. Volume 15, No.4, 2009.

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