California's Rural Health Clinics: Obstacles and Opportunities

Blue Sky Consulting Group

California's 271 rural health clinics are key providers of primary care to elderly and low-income populations. This report presents an overview of the patients they serve and the obstacles they face.

March 2012
Rural Medi-Cal Primary Care Visits

Rural health clinics (RHCs) provide primary care services to elderly and low-income populations in designated rural areas throughout the state. Providers certified as RHCs meet stringent federal criteria and receive cost-based reimbursement for Medicare and Medi-Cal services.

More than two-thirds of California counties do not have the minimum number of primary care physicians considered adequate to meet demand. In general, rural counties tend to have far fewer physicians per capita than urban counties. California's 271 RHCs fill some of this health care gap.

This snapshot presents an overview of RHCs to develop a better understanding of the care they provide and the obstacles they face. It is based on a study of publicly reported data and a survey of California RHCs.

Some highlights:

  • California RHCs in FY 2010 provided 44% of the total primary care in rural areas.
  • In FY 2010, 52% of RHCs were independent and owned by medical providers or community groups, while the other 48% were owned and operated by hospitals.
  • Even though it is not required, 48% of RHCs reported that they offered sliding scale discounts to uninsured patients in 2011.
  • Medi-Cal paid for 42% of visits, and Medicare paid for 22% of visits, to RHCs in the most recent fiscal years of the RHCs surveyed.
  • Many RHCs reported feeling financially unstable; almost 40% self-identified as unstable or very unstable. In addition, 56% of RHCs did not make a profit in their most recent fiscal year.
  • Although rural patients stand to benefit the most from telehealth applications, less than half of RHCs participated in telehealth activities in 2011.

Costs and limited resources were reported as the biggest challenges for RHCs generally, as well as the most important obstacles to increased use of electronic health records (EHRs) and telehealth.

The complete snapshot is available under Document Downloads.