兰德-了解加州的安全网-确定为Medi-Cal注册者提供初级保健的医疗保健提供者（英）

PETRA W. RASMUSSEN, AARON KOFNER, JOSHUA EAGAN, CHERYL L. DAMBERGUnderstanding California’s Safety NetIdentifying the Health Care Providers Delivering Primary Care to Medi-Cal EnrolleesAs of August 2024, more than 14.4 million individuals were enrolled in California’s Medic-aid program, better known as Medi-Cal. Many Medi-Cal enrollees receive their primary care from Federally Qualified Health Centers (FQHCs) (California Health and Human Services Agency, 2025). The literature surrounding FQHCs—which receive enhanced reimbursement for providing care to Medi-Cal enrollees—is considerable. Additionally, because of their regular reporting requirements to the Health Resources and Services Administration’s Health Center Program through the Uniform Data System (UDS), data on their provision of care are read-ily available (Rosenbaum et al., 2019). However, FQHCs are not the only sources that Medi-Cal enrollees turn to for their care. There are other non-FQHC clinics and providers that Medi-Cal enrollees rely on for their primary care. The care that non-FQHC providers deliver to Medi-Cal enrollees might be significant, but it is not well documented or understood. The extent to which different subgroups of Medi-Cal enrollees use non-FQHC providers for their primary care needs likely varies, and developing a better understanding of that variation could inform efforts to improve support for these providers and patient populations. Disparities in care are pervasive across the U.S. health care system, including within Medi-Cal. In particular, Black patients typically receive less-adequate care and have worse health outcomes compared with non-Hispanic White patients (Thomas et al., 2024). In addition, prior research has shown that visits by some patient groups tend to be concentrated in a small number of providers, suggesting that reaching these specific providers or provider groups with trainings and programs to help improve care quality could have a large impact on reducing disparities (Bach et al., 2004). Ongoing efforts aim to reduce these disparities within California and the Medi-Cal population to improve care for all (Cummings, 2022; Rittenhouse et al., 2023). To support this work, a better understanding of which providers deliver care to Medi-Cal enrollees is needed. Identifying the universe of providers who serve different subpopulations of Californians could help target supports to these providers to improve the quality of care they deliver to patients. Research ReportSummaryIn this study, we sought to develop an understanding of the providers that are delivering primary care ser-vices to Medicaid enrollees in California. In particular, we explored the degree to which individuals enrolled in Medi-Cal—California’s Medicaid program—use Federally Qualified Health Center (FQHC) and non-FQHC providers and how use of non-FQHC providers varies by enrollee characteristics, including race or ethnicity, age, and geography. To do so, we used Medi-Cal data from 2