PETRA W. RASMUSSEN, AARON KOFNER, JOSHUA EAGAN, CHERYL L. DAMBERG
Understanding California’s
Safety Net
Identifying the Health Care Providers
Delivering Primary Care to Medi-Cal
Enrollees
A
s 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 Report
