UCLA Evaluates Impact of COVID-19 Pandemic on WPC Program

The University of California, Los Angeles (UCLA) Center for Health Policy Research (CHPR) recently published an evaluation report that assessed how the COVID-19 pandemic impacted service utilization under the Whole Person Care (WPC) Program, the statewide Medi-Cal demonstration launched in 2016 to integrate medical, behavioral health, and social services for high-utilizing Medi-Cal beneficiaries.

The report found that 4.1 percent of WPC enrollees, or 8,738 participants, received at least one COVID-19-related service. Findings also demonstrated demographic and health differences between those with and without a COVID-19 diagnosis. For example, individuals with severe mental illness or substance use disorders (5.5 percent) had COVID-19 diagnoses. Patients with a COVID-19 diagnosis were further found to have a higher use of primary care (42 percent) vs emergency department visits (33 percent).

Researchers found reduced use of primary and specialty care services following stay-at-home orders issued in 2020 and compared to 2019, followed by an increase in the number of telehealth visits later in the pandemic. Changes in service use occurred with the 25 WPC Pilots participating in the program. Pilots reported challenges in delivering WPC services because of pandemic-related shutdowns and physical distancing requirements (20 pilots), hiring freezes (17 pilots), reduced ability to conduct field-based outreach to engage patients experiencing homelessness (16 pilots), and safety concerns and staff being reassigned to other COVID-19 response activities (17 pilots). Despite these challenges, pilots reported continued enrollment under WPC, easier access to enrollees at their homes (18 pilots), increased opportunities to house enrollees, and improved relationships with community partners to deliver care to individuals at higher-risk of contracting COVID-19.

Other key findings from evaluation include:

  • Overall enrollment in the WPC Program increased by 25.1 percent from December 2019 through December 2020 – 77,198 vs. 96,563 enrollees, respectively.
  • Patients with a COVID-19 diagnosis were more often women (47 percent vs. 44 percent), ages 50 to 64 (35 percent vs. 31 percent), and Latino (42 percent vs. 26 percent) compared to those without.
  • The number of emergency department visits declined in April 2020 compared to April 2019 and stayed lower in December 2020 compared to December 2019.
  • Trends in daily hospitalizations from COVID-19 mirrored trends in confirmed cases, peaking at 18 and 52 hospitalizations per 100,000 in July 2020 and December 2020, respectively.
  • Before the pandemic, less than 0.1 percent of primary and specialty health services were delivered via telehealth; the rate increased to two percent of primary and three percent of specialty services in March 2020, and nine percent of primary and 10 percent of specialty services in December 2020.

The program evaluation findings are intended to be used by the Department of Health Care Services (DHCS) to guide the implementation of the Enhanced Care Management (ECM) benefit under the sweeping CalAIM Initiative. Additional information on the evaluation report is available here.