Examining Access to Specialty Care for California’s Uninsured

Mathematica Policy Research


This is archived content, for historical reference only.

This issue brief attempts to answer the questions: How, and with what ease, are California’s uninsured able to obtain specialty care, and how does their experience vary around the state? The research team found widespread problems in access to specialty care for the uninsured, with many communities experiencing worse access compared to just a few years ago.

Mathematica Policy Research, Inc. conducted two statewide surveys of key safety-net providers including medical directors of federally qualified health centers (FQHCs) in California, and 64 hospitals where they commonly refer uninsured patients for specialty care. Case studies of the safety net for specialty care were also conducted in four communities.

Findings from the surveys include:

  • Eighty-five percent of the FQHC medical directors reported that their patients “often” or “almost always” have problems in obtaining specialty care.
  • FQHC medical directors characterized adults’ access as “often” or “almost always” problematic for 16 of the 24 specialties surveyed. Neurology, allergy/immunology, and orthopedics were among the specialties most frequently cited as problematic.
  • Waiting times for the most problematic specialties were often months long, as shown by the case studies and the hospital outpatient department survey.

The issue brief lists short-term action steps for local health leaders to assess and address specialty care for the uninsured, and longer-term implications for state and national policymakers. A full report that details the authors’ findings in greater depth is also available.

The issue brief and full report are available under Document Downloads below.