Physician Participation in Medi-Cal

University of California, San Francisco

This report uses data from a Medical Board of California survey; it finds that low participation rates are a continuing problem and discusses the implications for low-income patients.

July 2010

Medi-Cal, California's Medicaid program, covers nearly 7 million people. This number is expected to grow substantially in 2014 under new eligibility rules enacted as part of federal health care reform. Physicians' willingness to include Medi-Cal patients in their practices is essential if program beneficiaries are to have adequate access to care.

In 2008, with support from the California HealthCare Foundation, the University of California, San Francisco (UCSF), developed and conducted a new survey to determine levels of physician participation in Medi-Cal. The study found that low levels of physician Medi-Cal participation are a significant problem.

Among the study's findings:

  • California physicians are much less likely to have Medi-Cal patients (68%) than patients with private insurance (92%) or Medicare coverage (78%), with widely varying participation rates among specialties.
  • While 90% of California physicians are accepting new patients and 73% are accepting new Medicare patients, only 57% reported accepting new Medi-Cal patients.
  • Medi-Cal patients are concentrated in a small share of practices, with 25% of physicians providing care to 80% of Medi-Cal patients.

Given the uncertain impact of federal health care reform, it will be crucial for the state to monitor physician participation in Medi-Cal as an indicator of access to care among low-income residents. UCSF's new survey method provides an opportunity for California lawmakers to establish a regular, systematic method for collecting this key information from physicians.

This report explains the survey methodology, presents the survey's findings regarding the shortage of primary care and specialist physicians participating in Medi-Cal, and discusses the implications for low-income patients in the state.

The 2008 survey report, along with prior studies examining the issue, is available under Document Downloads.