California Leads U.S. in Total Number of Medicaid Beneficiaries

Medi-Cal enrollment has increased by 34% since the Affordable Care Act went into effect, leading all other Medicaid programs in the country in terms of total beneficiaries, according to data from the Kaiser Family Foundation, HealthyCal reports.

Medi-Cal is California’s Medicaid program.

Details of Increase in Enrollment

California — one of 29 states that have expanded their Medicaid programs under the ACA — has about 12.2 million beneficiaries. Before the ACA, Medi-Cal had an average of about 9.2 million beneficiaries.

According to the data, Medi-Cal has nearly twice as many beneficiaries as the next-closest state, New York, which has about 6.4 million residents enrolled in its Medicaid program. According toHealthyCal, California’s Medicaid program also had the highest number of beneficiaries in the country before the ACA.

However, while Medi-Cal’s insurance rolls are the largest in the country, California did not see the highest percentage increase in enrollment. Kentucky had the highest enrollment increase since the ACA took effect, at 88% (Guzik, HealthyCal, 6/15).

Medi-Cal Managed Care Physicians More Likely To Face Discipline After Poor Reviews

In related news, Medi-Cal managed care plan physicians who fail site reviews or pass on a conditional basis are more likely than other doctors to have received disciplinary action from the Medical Board of California, HealthyCal reports.

According to HealthyCal, managed care plans are required to conduct facility site and medical record reviews every three years at participating physician offices. To pass, physicians must:

  • Follow standard infection control procedures;
  • Meet staffing requirements;
  • Offer preventive care; and
  • Meet other metrics.

Findings of the reviews must be reported twice annually to the California Department of Health Care Services, which oversees Medi-Cal managed care plans.

While disciplinary action from the medical board is uncommon, an analysis of the latest state data shows that Medi-Cal managed care providers who failed reviews or passed conditionally are twice as likely as passing physicians to have been disciplined, HealthyCal reports.

Specifically, more than 6% of physicians with low site-review scores have a disciplinary record, compared with 3% of all California doctors (Urevich, HealthyCal, 6/15).

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