New Medical Group combines managed care and “street medicine” to address homelessness

With California’s homeless population surpassing 161,000, a new medical group called Healthcare in Action is being created to provide medical and other services to the homeless. In a recent interview, Michael Hochman, MD, a primary care physician and the first CEO of Healthcare in Action, described his approach to combining managed care and “street medicine.”

SCAN Group of Long Beach, California, which includes SCAN Health Plan, one of the nation’s largest nonprofit Medicare Advantage plans, is launching Healthcare in Action.

Hochman is a graduate of Harvard Medical School and the Robert Wood Johnson Foundation Clinical Scientist Program at the University of California, Los Angeles. He was appointed to lead the new medical group based on his experience as director of USC Gehr’s Family Center for Health Science and Innovation and as senior deputy health officer for former Los Angeles County Supervisor Mark Ridley-Thomas. In both roles, he was responsible for improving systems of care for low-income populations.

The new medical group will serve SCAN health plan members, as well as members of other health insurance plans.

The group will focus on providing “street medicine” to seniors, who make up one of the fastest-growing segments of the homeless population. In Los Angeles County alone, the number of homeless people over the age of 55 is projected to grow from 20,550 in 2011 to 36,045 in 2025, a 75 percent increase.

Hochman said that both objectively and anecdotally, Southern California’s homelessness crisis has gotten much worse over the past few years. “I’ve been working in Los Angeles County Health and Human Services for the last 11 years. Oddly enough, we’re just seeing it more and more. You know, until recently I was an attending physician at Los Angeles County Medical Center + USC, a large county hospital. Now almost 25 percent of the bed-bound patients are homeless, which is significantly more than ten years ago when I first started.”

Hochman said the new organization, scheduled to launch in January 2022, combines two different concepts that have proven successful in their own right: street medicine and managed care.

“Both SCAN CEO Dr. Sachin Jain and I worked with Boston Healthcare for the Homeless,” Hochman said. “I used to be at the University of Southern California, and they have a street medicine program. What’s good about it is that you get rid of the four walls of the traditional medical office, you take care of patients where they are on the streets, under bridges, in treatment facilities.

The problem with street medicine programs is that they usually require charitable funding. “These are great programs. There’s just no pathway to sustainability, so we combine that with managed care,” Hochman said. “Especially here in California, there are some really interesting groups that have taken high-need and high-value populations through managed care with distributed savings and risk-taking, and created sustainable models.” “Health Care in Action hopes to combine the concept of managed care with the street medicine model to create something sustainable and provide better care for patients.