Physician Shortage Could Hinder Calif. Bridge to Reform Program

Over the next few years, California's Bridge to Reform program aims to provide medical coverage for thousands of uninsured state residents, but officials say it will not address the shortage of primary care and specialty physicians, HealthyCal reports.

Background

The Bridge to Reform Medi-Cal waiver is a joint state and federal program that aims to help California prepare for wider implementation of the federal health reform law in 2014. Medi-Cal is California's Medicaid program.

The bridge program provides matching federal funds to counties for health care spending for low-income, uninsured adults.

Physician Shortage Concerns

The program calls for patients to have a primary care physician and for follow-up care that includes medications and lab tests to stave off potentially costly emergency treatment.

However, county officials say a shortage of primary and specialty care physicians will make it more difficult to meet the needs of those who will receive health coverage under Bridge to Reform and in 2014 under an expansion of the federal health reform law.

Mary Ann Lee, managing director of the Stanislaus County Health Services Agency, said there have been difficulties trying to recruit physicians under Bridge to Reform in part because "reimbursements (for Medi-Cal) are lower than many other states and the unemployment is higher, so there is higher uncompensated care."

Ken Cohen, director of health care services at San Joaquin County Health Care Services, said his county has "a significant manpower shortage," adding that more physicians practice in Los Angeles, San Francisco and San Jose.

Cost Concerns

County officials also have expressed concerns about whether the cost of adding patients and expanding coverage would exceed the amount of federal funds received.

If so, many counties that already are facing budget challenges would have to cover the extra costs of providing health care (Moran, HealthyCal, 7/20).

For more coverage on California's Bridge to Reform Medicaid waiver, see today's Feature article.