San Joaquin Valley: despite poverty and capacity constraints, health care access improves
- Collection:
- Health Policy and Services Research
- Series Title(s):
- California health care almanac (California HealthCare Foundation)
- Author(s):
- Finocchio, Len, author Paci, James, author
- Contributor(s):
- California HealthCare Foundation, issuing body.
- Publication:
- [Oakland, CA] : California Health Care Foundation, December 2020
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Health Services Accessibility California United States
- Genre(s):
- Technical Report
- Abstract:
- California's San Joaquin Valley is geographically and economically diverse. Known for rich irrigated farmland and agricultural output, the region is home to Fresno, a city of more than 500,000 residents. Across the region, which spans the counties of Mariposa, Madera, Fresno, Kings, and Tulare in the San Joaquin Valley, more than 20% of the 1.8 million residents have incomes below 100% of the federal poverty level (FPL). At the same time, there are pockets of affluence in the region, primarily in north Fresno, where providers vie for privately insured and Medicare patients. In 2019, nearly half of the residents in the San Joaquin Valley were covered by Medi-Cal (44%), and 8% were uninsured. Despite the expansion of the safety net after implementation of the Affordable Care Act (ACA), including growth of Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs), the San Joaquin Valley continues to face problems with access to care, especially for behavioral health services, and struggles to recruit physicians and other health care professionals. The COVID-19 pandemic--which hit the region particularly hard, though later than the rest of California--has compounded these challenges. The region has experienced a number of changes since the previous study in 2015-16 (see page 23 for more information about the Regional Markets Study). Key developments include: (1) While financial performance improved in larger hospitals, some independent hospitals struggled. (2) While many physicians continue to practice independently in solo or small practices, some are choosing to affiliate with hospitals. (3) FQHCs and RHCs continue to expand across the region, sparking competitive tensions in some areas. (4) While several hospitals have taken a leap toward global risk contracts, the movement toward risk-based arrangements for other providers has been slow. (5) Shortages of physicians and other health care professionals continue to plague the region, even with scholarships, loan repayments, and other recruitment incentives. (6) Data sharing among San Joaquin Valley providers remains challenging despite the presence of a health information exchange (HIE) serving the region's two largest counties, Fresno and Tulare. (7) Access to mental health and substance use disorder (SUD) services for Medi-Cal enrollees has been improving, though significant gaps in care remain. (8) Health and income disparities, as well as other sociodemographic factors, have worsened the impact of the COVID-19 pandemic in the San Joaquin Valley.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-ND license. (More information)
- Extent:
- 1 online resource (1 PDF file (22 pages, 1 unnumbered page))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101775791 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101775791