Preventing Unnecessary Hospitalizations in Medi-Cal: Comparing Fee-for-Service with Managed Care

Primary Care Research Center


This is archived content; for historical reference only.

One measure of Medi-Cal beneficiaries’ access to ambulatory care is preventable hospitalization rates. Preventable hospitalizations are admissions for conditions such as asthma, diabetes, and hypertension that can often be managed with timely and effective treatment in an outpatient setting.

This report shows that from 1994 to 1999 the preventable hospitalization rate was significantly lower for Medi-Cal beneficiaries enrolled in managed care than those in fee-for-service.

A related white paper, The Role of Provider Organizations in Medi-Cal Managed Care, examines findings from a 2003 survey of California medical groups, independent practice associations, community clinics, and hospital-based delivery systems. It reviews the scale and scope of these organizations; their investments in information technology; self-reported measures of profitability; and interest in expanding or decreasing the number of their Medi-Cal patients.

Both reports are available through the links below.