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Fresno: As Uninsured Rate Falls, Capacity Constraints Grow

Mathematica Policy Research

Insurance coverage and financial stability have greatly improved in the Fresno region, but capacity and access challenges have grown. 

While the Fresno region's largely agricultural economy has grown, it continues to be one of the poorest areas in California. Many who were previously uninsured were able to enroll in Medi-Cal under the Affordable Care Act (ACA). This helped bring financial stability to the region's health care sector but also compounded existing provider capacity constraints and access challenges.

Other key findings include:

  • Medi-Cal enrollment has grown, now covering 41% of the population in the region compared to 27% for California as a whole, since the January 2014 ACA coverage expansions.
  • The growth in insurance coverage exceeded expectations of providers and Medi-Cal managed care plans alike, leading to capacity challenges.
  • Rural Health Clinics (RHCs) continue to grow, exacerbating competitive tensions with some Federally Qualified Health Centers (FQHCs).
  • With the gains in Medi-Cal coverage and additional financial subsidies, the major hospitals and community health centers have generally experienced improvements in financial status.
  • In a notable shift from previous rounds of this study, physicians in Fresno County have started to consolidate into larger, more integrated medical groups.
  • Providers are taking on more risk in a market that has historically been almost exclusively fee-for-service.

The complete 2016 report and a quick reference guide, as well as previous years' editions, are available under Document Downloads.

CHCF has updated a series of issue briefs that examine the health care markets in seven regions of California: Fresno, Los Angeles, Orange County, Riverside/San Bernardino, Sacramento, San Diego, and the San Francisco Bay Area. These issue briefs highlight the state's changing health care systems following the implementation of the Affordable Care Act. They are published as part of the CHCF California Health Care Almanac, an online clearinghouse for key data and analyses examining California's health care system.

Almanac Updates

The CHCF Almanac regularly publishes data and analysis on California's health care market.

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