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Uninsured patients have higher rates of emergency department (ED) utilization and less access to primary care services than those with insurance. The California Health Care Coverage Initiative, funded through a Medicaid waiver, was designed to increase uninsured adults' adherence to a single primary care provider. Participating counties were required to establish a safety-net-based provider network, create a package of covered benefits, and assign each beneficiary to a medical home.
This study evaluated the impact of the program on use of ED and hospital services in Orange County, where more than 49,000 uninsured adults were enrolled during the 3-year program. During the first 2 years, adherence to a single primary care provider was not requ…