A new study shows that the Path to Health program, launched as a pilot program by the County Medical Services Program (CMSP) Governing Board from 2019 to 2023, delivered significant advancements in healthcare access for low-income, undocumented adults across 35 mostly rural counties in California. The program, independently evaluated by UCLA’s David Geffen School of Medicine, highlights the potential for tailored healthcare solutions to bridge gaps in care and offers insights to inform future public health initiatives statewide.

Designed to address a critical lack of healthcare coverage for undocumented adults prior to the expansion of Medi-Cal in 2024, the Path to Health program provided primary care services and coverage to over 19,400 participants throughout CMSP’s 35-county service area. The program sought to reduce delays in care, hospitalizations, and emergency department use for undocumented adults who were enrolled in emergency services-only (restricted scope) Medi-Cal. Most program participants were individuals of Latino/Latina heritage and Spanish-speaking adults ages 21–64, who were provided a wide array of core health services, including primary care, prescription medications, and COVID-19 vaccinations.

Key Findings

A comprehensive evaluation of the program, conducted by UCLA’s David Geffen School of Medicine, utilized a combination of enrollment data, healthcare claims data, and survey responses. The results underscore the program’s success in improving healthcare access, health outcomes, and potential savings resulting from a reduction in higher-cost medical treatments.

• Emergency Department and Hospitalization Reductions: By the end of the program, participants reported up to a 22% decrease in emergency department visits and up to a 24% reduction in hospital admissions. These significant declines in high-cost medical treatments highlight the potential cost savings of preventive care.
• Chronic Condition Management: Services targeted chronic diseases such as diabetes, hypertension, and cholesterol/hyperlipidemia, reducing complications through consistent treatment and medication. At least 40% of enrolled members had pre-existing conditions, making them a vital target for primary care management to prevent more costly medical interventions later.
• Telehealth and Vaccination Success: Telehealth visits and COVID-19 immunizations played a critical role in expanding access to care, particularly during the pandemic. The Path to Health program covered 21,915 telehealth visits to primary care professionals and increased access to on-site radiology, lab testing, and prescription medications.
• Growing Demand for Affordable Care Delivery: The pilot program demonstrated how preventive care and chronic disease management can reduce reliance on high-cost acute care services. Path to Health processed 32,606 enrollment transactions during the study period, including more than 19,400 first-time enrollments, with cumulative enrollments steadily increasing throughout the pilot program’s duration.
• Local Partnerships: Partnerships with local clinic organizations were essential to the program’s success. Clinics provided critical resources and strongly endorsed the pilot program as a valuable tool for improving underserved populations’ care.

“Through strategic partnerships with community health centers in the CMSP counties, the Path to Health program expanded access to essential health care services for a portion of California’s underserved safety-net population,” said Kari Brownstein, Executive Director of CMSP. “UCLA’s independent analysis confirms that a strategic approach can improve health and reduce unnecessary, more expensive healthcare costs. Path to Health provides strong evidence that a sustainable healthcare delivery system needs to focus on prevention and primary care.”

At the end of the four-year program, members self-reported significant improvements in their health status, comparing their first and last enrollment surveys. These results validate the program’s effectiveness in addressing chronic conditions and enhancing overall well-being.

“The program served as a lifeline for those without access to primary care services, setting a precedent for equitable and inclusive healthcare delivery,“ said Gerardo Moreno, MD, MSHS, principal investigator of the study and Department Chair of Family Medicine at UCLA David Geffen School of Medicine.

The Path to Health program study results were presented to the CMSP Governing Board at the end of 2024. The results are now being made available statewide to healthcare providers and leaders, public health officials, and policymakers to help inform their own healthcare program delivery.

About the County Medical Services Program (CMSP)

The County Medical Services Program has been a cornerstone of healthcare for underserved and uninsured populations across 35 counties in California for the past four decades. CMSP is a government entity created through a statute that provides health coverage for uninsured, low-income, adults who are not otherwise eligible for other publicly funded healthcare programs. CMSP’s Governing Board, charged with overall program responsibility, aims to narrow the healthcare gap, ensure better outcomes for communities in need, and champion equitable access to care in predominantly rural areas in California.

CMSP programs are putting vital healthcare coverage options and access to services within reach for underserved populations in these 35 California counties: Alpine, Amador, Butte, Calaveras, Colusa, Del Norte, El Dorado, Glenn, Humboldt, Imperial, Inyo, Kings, Lake, Lassen, Madera, Marin, Mariposa, Mendocino, Modoc, Mono, Napa, Nevada, Plumas, San Benito, Shasta, Sierra, Siskiyou, Solano, Sonoma, Sutter, Tehama, Trinity, Tuolumne, Yolo, and Yuba.