Significant portion of primary care provided to Medi-Cal enrollees delivered at FQHCs, new CHCF report finds


Soraya Marashi


Federally qualified health centers (FQHCs) and related clinics, such as Look-Alikes (LALs) and Rural Health Centers (RHCs), provide a significant portion of primary care visits to Medi-Cal enrollees, according to a new report published by the California Health Care Foundation (CHCF).


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The report specifically found that FQHCs, LALs, and RHCs delivered nearly 44% of all primary care visits provided to Medi-Cal enrollees between 2017 and 2019. 

While these clinics provide a substantial percentage of primary care visits for Medi-Cal enrollees across all races and ethnicities, the report notes that the highest percentages of primary care visits provided by these clinics is for white and Latino/x individuals (45.3% and 45.2%, respectively). This is compared to 38.1% for Black individuals, 37.2% for American Indian and Alaska Native individuals, and 35.6% for Asian, Native Hawaiian, and Pacific Islander individuals.

The percentage of primary care visits provided by these clinics to Medi-Cal enrollees is also highest in the regions of the North Coast/Far North and Central Valley. The image below shows that the Central Valley region has the highest total number of primary care visits attributable to FQHCs and related health centers, representing nearly 7.7 million, or 55.2%, of all Medi-Cal primary care visits.



While the North Coast/Far North region has a lower overall number of Medi-Cal primary care visits, the following image shows that the region has the highest percentage of primary care Medi-Cal visits provided by FQHCs, LALs, and RHCs, representing 71.5% of these visits across 8 counties in the region. Modoc and Mendocino Counties have the highest percentages within the region. The Southern California region (excluding Los Angeles) and Los Angeles County itself have the lowest percentages.



The report also found that there is significant variation in primary care numbers based on Medi-Cal aid code, as shown in the image below. The “Other_1” code made up 84.9% of primary care visits provided by FQHCs, LALs, and RHCs, representing the highest percentage, and the “Adoption Assistance” code made up 33.3%, representing the lowest percentage.



The report emphasizes the importance of these findings for policymakers and health care professionals monitoring the effectiveness, cost, and demand of Medicaid services. 

“Administrators, policymakers, health professional groups, and many others are interested in better understanding what influences Medicaid spending in order to contain health care expenditures and to improve the value realized for those expenditures. Additionally, analysis of the utilization of health services (i.e., benefits) supports those goals by providing information about service demand, whether the population’s service needs are met, whether resources are allocated appropriately, the quality and effectiveness of those services, and the relative influence of various services on Medicaid spending.”

It is also necessary to use this data to better understand where people of color not going to FQHCs and related clinics are accessing primary care, the report states, as well as to provide more readily accessible, comprehensive, and timely Medi-Cal utilization data.