Riverside/San Bernardino: Despite Large Medi-Cal Expansion, Many Uninsured Remain

Mathematica Policy Research


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Riverside and San Bernardino Counties continue to recover from the devastating economic effects of the 2008 recession. Income levels in the region remain relatively low, and employment growth is characterized by lower-wage jobs with fewer health insurance benefits.

Seventeen percent of residents in this region lacked coverage by the end of 2014 compared with just under 12% for California as a whole, although Medi-Cal enrollment continued to climb throughout 2015.

Other key findings include:

  • The market continues to grapple with a short supply of hospital beds and physicians, particularly primary care physicians and psychiatrists. Many hospitals lack the financial resources to build new capacity and address state seismic requirements.
  • While many physicians remain in independent or small practices, an eroding payer mix and other pressures are driving physicians to seek help in remaining independent or to trade independence for the stability of larger organizations like Kaiser.
  • Despite some improvements, the community lacks a robust, extensive safety net to adequately serve the health care needs of people with low incomes.
  • Some hospitals are making organizational changes and establishing the building blocks of integrated delivery systems.

Since 2009, CHCF has published a series of regional market studies that examine the health care markets in specific regions across California. These studies highlight the range of economic, demographic, and health care delivery and financing conditions in California. 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.