About 30,000 low-income Minnesotans who rely on General Assistance Medical Care were able to stay in the program as part of budget negotiations at the State Capitol last month.
But many of the program changes, which start today, could take some getting used to for both the patients and medical providers.
The program was cut by about 75 percent, so the scaled-back program will force hospitals that treat GAMC patients to cope with less.
In the Twin Cities, four hospitals will care for those on GAMC using a coordinated care delivery system in which hospitals would get a lump sum of money to care for a certain number of patients.
At one of those hospitals, the University of Minnesota Medical Center-Fairview, officials said they will have to work to establish a relationship with GAMC patients.
"We recognize that this is a disruption for them," Marge Page, a nurse and vice president at the hospital, told MPR's Morning Edition. "We need to reestablish that relationship with them."
Coordination will be needed not only because the hospitals are getting less money from the state, but also because thousands of people come onto or transition out of GAMC, Page said.
"We know from data from the state that most of these folks are in GAMC for three to five months," she said.
That means while about 30,000 people are on GAMC at any given time, the program might serve up to 75,000 people a year, she said.
Hospitals will try hard to keep patients healthy and out of the hospital emergency rooms, where expenses can add up fast.
Hospitals had hoped the state would adopt an early expansion of Medical Assistance so that GAMC patients could be cared for with federal dollars. But the soonest that's likely to happen is after a new governor takes office in January.
For now, hospitals will try to make do.
"We are going to make the very best of an imperfect model," Page said.
(MPR's Cathy Wurzer contributed to this report.)