The population of the Fresno area has grown rapidly in the past decade, but residents have lower income, education, and health insurance levels, and worse health status than average for California. The economic downturn is intensifying an already bleak situation in this area of high poverty, unemployment, and lack of health insurance.

To provide more perspective on the unique challenges facing Fresno and other large health care markets in California, CHCF asked the Center for Studying Health System Change to produce a regional market study in six areas: Fresno, Los Angeles, Riverside/San Bernardino, Sacramento, San Diego, and the San Francisco Bay Area. These reports are published as part of CHCF's California Health Care Almanac.

Key findings for the Fresno report include:

• Medi-Cal enrollment is high in the Fresno area, with about one in three residents enrolled in both Fresno and Tulare Counties.
• Fresno’s physician workforce is aging, and the supply is inadequate to meet population needs.
• Fresno’s safety net is fragmented, with little coordination among providers.
• Access to care for low-income people is seriously hampered by shortages of health care professionals.
• Physicians are reluctant to accept Medi-Cal patients because of low reimbursement rates.

The complete issue brief and an executive summary are available under Document Downloads. An addendum to the brief is included under Related CHCF Pages.

Also under Related CHCF Pages is a link to a blog post titled "Fresno Region: Competition's Role in this Stressed Health Care Market?" by Norma Forbes, which includes reader comments. Click through to this page to join the discussion about the challenges of providing care in the Fresno area.