Dr. Clara Horton discusses Laguna Honda patients' transition to managed care plans

The July 4, 2025, meeting of the San Francisco Health Network focused on critical updates regarding the integration of long-term care services into the CalAIM initiative. The session began with a discussion led by Ms. Louis, who addressed concerns about capital project investments and the need for enhanced identification systems for clinicians to manage care plans more effectively.

Commissioner Green raised questions about the implications of working with health plans and the assignment of CPT codes on the network's revenues. He expressed confusion regarding the health plan options available to residents of Laguna Honda, particularly the distinction between the San Francisco Health Plan and Anthem Blue Cross. In response, Dr. Clara Horton, Chief Medical Officer of the San Francisco Health Network and acting CMO of Laguna Honda Hospital, provided clarity on the managed care landscape.

Dr. Horton explained that the network operates under a two-plan model, with 88% of patients enrolled in the San Francisco Health Plan and 12% in Anthem Blue Cross. She detailed the process by which patients are assigned to health plans, emphasizing the importance of quality scores and market share in determining these assignments. Dr. Horton also noted that all 553 residents of Laguna Honda would transition to managed care, with assistance from the social services team to navigate the selection process.

The meeting concluded with a commitment to ensure that residents understand their health plan options and the implications of the CalAIM initiative. The discussions highlighted the ongoing efforts to improve care coordination and the importance of clear communication with patients regarding their healthcare choices. The next steps involve continued collaboration with health plans to enhance service delivery and patient outcomes.