A look at SCAN's new medical group for homeless patients

SCAN Group, which owns SCAN Health Plan, is launching a new medical group that aims to provide specialized care to patients struggling with homelessness.

The new medical group, Healthcare in Action, will serve SCAN's members and is seeking partnerships with other health plans. The group will provide "street medicine" to seniors, which is one of the fastest-growing homeless populations.

For example, in Los Angeles County, the number of homeless people over the age of 55 is expected to grow from 20,550 in 2011 to 36,045 by 2025, an increase of 75%, SCAN said.

Healthcare in Action will begin to offer services on Jan. 1 in several communities in Southern California.

Sachin Jain, M.D., CEO of SCAN Group and SCAN Health Plan, told Fierce Healthcare that part of the goal is to reorient the discussion about homelessness to treat it as a healthcare issue, not merely a housing issue.

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He said that typically the first response to an issue with homelessness is to build more housing, but it's also critical to address underlying health needs that may be leading to a patient's housing instability.

"We haven't defined the issue of homelessness very well," Jain said.

The care team will include clinical experts including doctors, physician assistants and nurse practitioners working alongside social workers, community health workers and substance abuse counselors.

Michael Hochman, M.D., who will become CEO of Healthcare in Action, told Fierce Healthcare that the makeup of the team is critical to helping patients secure housing and stay housed for the long term.

Peer mentors, for example, he said, offer inspiration and a path out of homelessness that patients can follow, and their voices are highly effective in motivating patients who may otherwise feel hopeless.

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Hochman added that the street medicine approach also builds a key bond of trust that can make it more likely that a patient will accept help with their housing needs.

"With that trust you get between a doctor and patient, we’ll have more success in getting patients in housing at the right time," Hochman said.

Another key component of the medical group's design is that it is built on risk-based and value-based care concepts, SCAN said. The group will focus initially on people enrolled in Medicare and dually eligible members and will operate in a capitation model that enables flexibility for providers.

Jain said that the SCAN team described the program as "running toward adverse selection" as it invests heavily in providing better care for some of the highest acuity patients in a non-profit model.

"Many folks think we're crazy," Jain said. "Health plans historically were accused of running away from the sickest patients in healthcare and in this particular situation we’re running toward the sickest patients in healthcare."