Summary: 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.
Findings: Some key findings include:
- While financial performances improved in larger hospitals, some independent hospitals struggled.
- While many physicians continue to practice independently in solo or small practices, some are choosing to affiliate with hospitals.
- FQHCs and RHCs continue to expand across the region, sparking competitive tensions in some areas.
- While several hospitals have taken a leap toward global risk contracts, the movement toward risk-based arrangements for other providers has been slow.
- Access to mental health and substance use disorder (SUD) services for Medi-cal enrollees has been improving, though significant gaps in care remains.
- Health and income disparities, as well as other sociodemographic factors, have worsened the impact of the COVID-19 pandemic in the San Joaquin Valley.
This report used data from the 2018 California Health Interview Survey (CHIS).
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