Nearly Half of California Doctors Do Not Treat Medi-Cal Beneficiaries, Survey Says
Nearly half of primary care physicians and specialists in California do not treat patients enrolled in Medi-Cal, according to a report from the California HealthCare Foundation's Medi-Cal Policy Institute. According to the study, 45% of primary care physicians and 43% of specialists say that they do not have any Medi-Cal beneficiaries in their practices (CHCF release, 2/11). Conducted for the foundation by researchers at the University of California-San Francisco, the report examined physician surveys from in 1996 and 1998 to determine physician participation in Medi-Cal and physician attitudes toward the program. The following summarizes the key findings of the report.
- In 1998, 55% of primary care physicians and 57% of specialists surveyed said they treated Medi-Cal beneficiaries. According to the surveys, the percentages of doctor participation in Medi-Cal did not change significantly from 1996 to 1998.
- On average, Medi-Cal beneficiaries accounted for 11% of primary care physicians' patients and 7% of specialists' patients. Among physicians surveyed in 1998, half said that less than 5% of their patients were enrolled in Medi-Cal.
- Medi-Cal participation among specialists ranged from 41% for orthopedic surgeons to 67% for obstetrician/gynecologists.
- The ratio of primary care physicians to Medi-Cal beneficiaries in 1998 was 38 per 100,000, "well below" the Health Resources Services Administration's recommended workforce standards.
- Spanish-speaking physicians and those from "underrepresented minority groups" were more likely to accept Medi-Cal beneficiaries. Also, international medical graduates or physicians not board-certified were more likely to treat Medi-Cal patients (Bindman et al., "Physician Participation in Medi-Cal, 1996-1998," CHCF Medi-Cal Policy Institute, February 2002).
While the study acknowledged its limitations -- the findings are based on physicians' responses and may not reflect actual practice -- the report concluded that California needs to "reconsider its strategies" to increase physician participation in the program. Although doctors said reimbursement rates are low, the study notes that increasing payments has had only a limited impact on increasing participation in other states' Medicaid programs. Also, given that many physicians have concerns about the program's "administrative hassles," addressing that issue may help increase physician participation, the report says. Cultural diversity is also a factor in increasing physician participation, but as the number of minority physicians in the state is "disproportionately small," the state needs to develop a more "diverse physician workforce," the report said. The study also concluded that there should be a "commitment" to "evaluate strategies" designed to improve the program and its performance ("Physician Participation in Medi-Cal, 1996-1998," CHCF Medi-Cal Policy Institute, February 2002). The report is available at http://admin.chcf.org/documents/mcpi/PhysicianParticipationMediCal1996to1998.pdf.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.