Los Angeles County is building a system that would let every hospital in the county screen patients for financial aid before billing them, KFF Health News reported Oct. 8.
About 800,000 county residents have medical bills they can’t pay, according to county public health officials. Now the county, the region’s hospital association and a local health plan are working to stop that debt before it starts.
Five things to know:
1. Naman Shah, MD, PhD, a physician and epidemiologist with the Los Angeles County Department of Public Health, has led the county’s medical debt initiative since 2023. He estimates the presumptive eligibility system, which automatically screens and qualifies low-income patients for financial aid without requiring an application, could prevent several hundred million dollars in medical debt each year.
2. The Hospital Association of Southern California agreed to buy the system and make it available to its members, using bulk purchasing to lower costs for individual hospitals. The association was initially wary of the county’s initiative. “They’re turning their wheels trying to collect on debt that isn’t collectable,” Adena Tessler, the association’s regional vice president, said of hospitals’ current collection efforts.
3. L.A. Care, a nonprofit health plan that administers Medicaid coverage for more than 2.5 million county residents, committed $2 million to set up the system. The partners hope to launch it by January 2027.
4. About one in five hospitals in the county use presumptive eligibility tools today, according to Dr. Shah. He said hospitals that use them have reported up to a 50% increase in the financial aid they provide. A 2025 state law requires all California hospitals to begin presumptive eligibility screening by July 2027.
5. It’s unclear how many of the county’s 88 acute care hospitals will adopt the system, and long-term funding has not been determined. The partners also plan to link the system to California tax records to give hospitals more accurate patient income data.
