Inland Areas Gird for Medi-Cal Expansion Amid Doctor Shortage

California's inland communities are facing a shortage of primary care physicians as the state prepares to implement a Medi-Cal expansion under the federal health reform law, the Victorville Daily Press reports.

Medi-Cal is California's Medicaid program.

Background

The federal health reform law will expand Medicaid coverage to people with incomes of up to 133% of the poverty level. The law also will expand coverage to low-income adults who have no children.

San Bernardino County will add about 125,000 Medi-Cal beneficiaries, according to Inland Empire Health Plan, which serves Medi-Cal beneficiaries in the county.

Physician Shortage

According to the Daily Press, inland communities will have more residents receiving Medi-Cal coverage under the expansion than wealthier coastal communities.

However, the state has an uneven distribution of physicians. For example, Riverside and San Bernardino counties have only one medical school and struggle to attract and retain physicians, while some counties in the northern part of the state have an abundance of doctors.

Accounting to the 2011 County Health Rankings, there is one primary care physician for every 1,201 San Bernardino County residents, compared with one primary care doctor for every 847 state residents.

Richard Olds -- founding dean of UC-Riverside School of Medicine -- said, "I don't think people realize that manpower shortage in some areas in inland California is below where the third world countries are."

In addition, an article by the California HealthCare Foundation's Center for Health Reporting reports that nearly half of primary care physicians in the state are not willing to see new Medi-Cal beneficiaries. The Center is supported by a grant from CHCF, which publishes California Healthline.

Some physicians do not want to accept the beneficiaries because they consider Medi-Cal reimbursements to be too low, according to the Daily Press.

Efforts To Address Physician Shortage

UC-Riverside School of Medicine was created to address the shortage of primary care physicians in Riverside and San Bernardino counties. It is scheduled to open in 2013.

Olds said that high schools in the region should bolster health care programs to encourage students to become doctors and that local hospitals should offer sufficient training and residency programs (Shimura, Victorville Daily Press, 7/5).