Fewer Doctors Enrolled in Low-Income Insurance Program Despite Surge in Patients

July 14, 2014

By Hannah Guzik

Nearly 25 percent fewer physicians were signed up to treat low-income patients in the state’s insurance program this spring compared to a year prior, despite the surge in patients enrolled in Medi-Cal.

The drop in providers is due to the Department of Health Care Services’ efforts to remove doctors who haven’t complied with application requirements or billed the program in a year, spokesman Anthony Cava said.

“This has not resulted in a decrease in access to care,” he said.

More than 2 million people have signed up for Medi-Cal, the state’s low-income health plan, since the program was expanded under the Affordable Care Act. In total, 10.6 million people are enrolled — a quarter of the state’s population.

An additional 600,000 people are still waiting for the state to process their applications.

About 109,000 physicians were enrolled in Medi-Cal last spring, according to the Health Care department. But by this May, that number had dropped to 82,605.

Of the doctors enrolled in May, 38,845 were primary-care providers and 43,760 were specialists.

In the last year, the Health Care department has updated its provider requirements, as part of the Affordable Care Act, Cava said. Those requirements “have strengthened the department’s ability to deny or terminate providers who do not comply with application requirements,” he said.

On its own, the agency’s list of providers isn’t necessarily a reflection of whether Medi-Cal patients have sufficient access to doctors. The list doesn’t specify whether the doctors are accepting new patients or how many they can accept, Cava said. While some doctors on the list may have up to 2,000 Medi-Cal patients, others might see only a handful or none.

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