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What portion of Medi-Cal primary care visits are provided by health centers?: an analysis by region, race, and ethnicity
What portion of Medi-Cal primary care visits are provided by health centers?: an analysis by region, race, and ethnicity
- Collection:
- Health Policy and Services Research
- Author(s):
- DuPlessis, Helen M., author
Goddeeris, Mary, author - Contributor(s):
- California HealthCare Foundation, issuing body.
- Publication:
- [Oakland, CA] : California Health Care Foundation, May 2022
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Ambulatory Care Facilities -- statistics & numerical data
Ethnicity
Medicaid
Primary Health Care -- statistics & numerical data
Racial Groups
California - Genre(s):
- Technical Report
- Abstract:
- The Medicaid program constitutes an important and growing source of health care coverage for the country as a whole and for California in particular. The percentage of the population covered by Medicaid/CHIP programs increased in California from 15.2% in 2008 (13.4% in the US) to a high of 27.2% in 2016 (20.8% in the US). It increased again in 2020 due in part to the adverse economic consequences of the COVID-19 pandemic and the concomitant participation of additional states in the Medicaid expansion. In 2019, Medicaid/CHIP accounted for 17.4% of all health care expenditures in the US, and Medi-Cal (the Medicaid/CHIP program in California) accounted for over 33% of the total California budget. This report seeks to enhance stakeholder understanding of the role of FQHCs as Medi-Cal providers by offering a reliable estimate of the contribution of Federally Qualified Health Centers and related types of health centers to primary care visits for Medi-Cal enrollees. This analysis resulted from a collaboration with the California Department of Health Care Services’ Data Management and Analytics Division (DMAD) in response to a request in accordance with the Public Records Act. Federally Qualified Health Centers (FQHCs) and similar community health centers are an important component of the health care safety net. Annual reporting by FQHCs and FQHC Look-Alikes (LALs) to the Human Resources and Services Administration (HRSA) indicates these clinics provided services to over 5.5 million Californians in 2019, at least 65% of whom were Medi-Cal enrollees. Although these clinics report to both HRSA and the Department of Health Care Access and Information (formerly the California Office of Statewide Health Planning and Development), limitations on utilization data by payer source make it difficult to assess the attribution of specific services delivered by FQHCs and related clinics. Consequently, it is difficult to assess, for example, what percentage of primary care visits by the Medi-Cal population are provided by FQHC and related clinics. Administrators, policymakers, health professional groups, and many others are interested in better understanding what influences Medicaid spending in order to contain health care expenditures and to improve the value realized for those expenditures. Additionally, analysis of the utilization of health services (i.e., benefits) supports those goals by providing information about service demand, whether the population’s service needs are met, whether resources are allocated appropriately, the quality and effectiveness of those services, and the relative influence of various services on Medicaid spending.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-ND license. (More information)
- Extent:
- 1 online resource (1 PDF file (21 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 9918557473406676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918557473406676