Drop in Percentage of Physicians Participating in Medi-Cal Raises Red Flags


http://www.chcf.org/aca-411/insights/physician-participation?_cldee=aGVucnlrb3R1bGFAeWFob28uY29t

Physician Participation in Medi-Cal from 2013 to 2015

The share of physicians accepting new Medi-Cal patients is an indicator of the program’s capacity to meet demand. If a decreasing share of participating physicians are willing or able to take new Medi-Cal patients, beneficiaries in the program may have trouble getting the care they need. The proportion of physicians accepting new Medi-Cal patients has historically lagged behind the proportion accepting new patients covered by Medicare, which has a higher reimbursement rate, as well as behind the proportion accepting new patients with private health insurance.

New 2015 data now available on ACA 411 show the percentage of physicians participating in Medi-Cal has declined since 2013 — during the same period Medi-Cal enrollment skyrocketed by 39%. This raises serious concerns about whether the supply of physicians participating in Medi-Cal can meet the increased demand.

Physicians’ willingness to treat Medi-Cal beneficiaries is critical to ensuring Medi-Cal enrollees have adequate access to care. Without a sufficient number of doctors serving Medi-Cal beneficiaries, Medi-Cal enrollees may not be able to receive care in a timely manner. Beneficiaries may delay seeking needed care with disastrous effects or may end up receiving care in more costly settings.

 

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