Hospital Diverting Some of the Poor : Medicine: UCLA is expected to send about 1,000 Medi-Cal patients a year to Queen of Angels in an economy move.

In a move prompted by the growing crisis in the state Medi-Cal system and by financial motives, UCLA Medical Center this week began diverting indigent patients from its emergency room to Queen of Angels-Hollywood Presbyterian Medical Center, officials at both hospitals said.

About 1,000 Medi-Cal patients are expected to be transferred each year from UCLA, mostly by ambulance, to the Hollywood hospital. Only those patients who do not face “acute,” or life-threatening situations, will be transferred, the hospital officials said.

The agreement, reached last week by the two hospitals, points to the increasing disparity in health services available to those who are privately insured and those who must rely on state-funded health insurance. Officials at the state Department of Health Services said that to their knowledge the agreement was the first of its kind in California.

UCLA Medical Center is considered one of the best hospitals in California. But Queen of Angels-Hollywood Presbyterian Medical Center has come under fire in recent years for the quality of care it provides to its patients, 85% of whom are poor.

Officials at UCLA Medical Center said the patient transfer is only one of a series of efforts designed to reduce the number of patients at UCLA with Medi-Cal insurance.

“Over the years, the reimbursement level from Medi-Cal has deteriorated,” said Mark Laret, associate director of Marketing and Planning for UCLA Medical Center. “It has not kept pace with our increasing costs.”

Other hospitals have similar complaints about the Medi-Cal system. In August, the California Assn. of Hospitals and Health Systems filed a lawsuit on behalf of California’s 567 hospitals, contending that the state Medi-Cal program has illegally underpaid them by millions of dollars to treat indigent outpatients.

UCLA has consistently posted excess revenues--in the 1989-90 fiscal year, the hospital made $24 million. But hospital administrators say a decline in Medi-Cal reimbursements is costing the hospital millions of dollars each year, threatening the prestigious research projects that have made it a “world-class” institution.

“Our mission is to do research and to provide medical education and services to the community,” Laret said. “We have provided service to people who cannot afford to pay in such large quantities that it has threatened the research that has made us world-renowned and the education of the future physicians of California.”

About 30% of the patients at UCLA Medical Center are Medi-Cal recipients, Laret said. The hospital would like to see the proportion of Medi-Cal recipients drop to about 22%, he said.

A recent article in the medical center’s newsletter lists a series of proposed and already existing measures designed to reduce the number of Medi-Cal patients at the hospital. Some clinical departments at the hospital have begun to limit outpatient appointments to “control the numbers of new Medi-Cal patients who enter the UCLA system,” the article says.

While it is seeking to turn away Medi-Cal patients, the medical center also has launched a campaign designed to attract more privately insured patients. Newspaper ads--which first began appearing in the Los Angeles Times Westside section this summer--are promoting a new physician referral service.

“Now all you have to do to get an appointment with a UCLA physician is pick up the phone,” one advertisement reads, adding that physicians on the faculty of UCLA’s School of Medicine have helped make UCLA “the No. 1 medical center in the West.”

By contrast, the hospital to which UCLA has begun sending some of its Medi-Cal patients was recently criticized for its poor conditions by the Joint Commission on the Accreditation of Healthcare Organizations.

In July, the commission placed Queen of Angels-Hollywood Presbyterian Medical Center on conditional accreditation, a classification reserved for hospitals with significant problems in meeting quality-of-care and safety standards.

Hospital President Ron Dahlgren said Queen of Angels’ agreement with UCLA could bring the hospital $630,000 in additional monthly revenue. The Hollywood hospital lost $11 million last year, Dahlgren said.

Jim Ringrose of the California Medical Assistance Commission, which negotiates contracts between hospitals and the state Medi-Cal program, said he felt the agreement was a practical way to address the widely different problems faced by the two hospitals.

“UCLA is a highly specialized . . . teaching hospital; Hollywood Presbyterian is a primary-care community hospital,” Ringrose said. “One hospital wants patients and the other . . . simply can’t accommodate more Medi-Cal patients. (The agreement) is a win-win situation for both hospitals.”