California Doctors Who Treat Poor Get Reimbursement Boost

California is boosting reimbursement payments for doctors and dentists who treat the state’s poorest residents. It’s part of an incentive to expand access under Medi-Cal, which offers free or low-cost health coverage to more than 13 million people — a third of the state’s population.

“The ultimate goal here is to make sure Medi-Cal beneficiaries get access to care when it’s needed, where it’s needed,” said Dr. Ted Mazer, an ear, nose and throat surgeon and president of the California Medical Association. “Instead of what Medi-Cal beneficiaries have been going through for years, which is struggling to get care.”

Under the new state budget, doctors are receiving a pay hike for several services, including preventative care and regular office visits. The $2 billion program is funded in part by Proposition 56, a state tobacco tax that took effect last year.

Previously, doctors were paying a hefty price to take on Medi-Cal patients because reimbursements were insufficient, Mazer said. Medi-Cal payments were approximately half of what doctors received through Medicare, the government-run health insurance program for seniors.

“The problem with low reimbursement isn’t that doctors aren’t making money, it’s that the doctors and hospitals are paying out of pocket to give care to Medi-Cal beneficiaries,” he said. “There’s a limit what you can do in a private practice world to keep the doors open.”

Mazer said the pay hike will allow doctors to take on more Medi-Cal patients.

“We hope to get the education out there to make those doctors understand, if you’re not seeing Medi-Cal now, you should be starting to, based upon these incentives,” he said. “If you are, you should be able to see more patients, because what used to be awful payments for these services are now more reasonable.”

More than $200 million of the funding will go to newly graduated doctors and dentists to help pay off their student loans if they commit to serving patients in underserved areas.


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