The Primary Care Physicians Shortage in California

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The state of California is facing an increased shortage of primary care physicians especially – with a rise in the number of the elderly population in the State leading to an increase in health coverage under Federal Health care reforms. Additionally, 30% of primary care physicians in the state are nearing retirement being above 60 or older- the highest percentage in any state.

However, compared to the shortage, the State has not significantly increased the number of primary care physicians trained. HHS’s Council on Graduate Medical Education recommends 60 to 80 primary care physicians per 100,000 people to adequately serve a population. Statistics show in fast-growing regions of California such as the Inland Empire there are only 40, whereas in low-income rural communities where care for 25% of patients is paid by Med-Cal, there are only 45 primary care physicians.

Even though medical school applications have been high in California, with a high proportion of U.S. medical school graduates filling all of the 2011 family medicine slots, state and federal policy decisions too need to be on the same lines. However, the State of California is trying to reduce physician fees by 10% in the Medicaid Program, putting physician payment at risk. According to the California Academy of Family Physicians (CAFP), a comprehensive state and nationwide effort would be able to effectively solve this shortage.

Tackling the Shortage Issue of Primary Care Physicians

Increase the number of medical schools – The State and federal policies need to encourage funding for higher education and primary care residency programs. The absence of this funding may lead to students being pushed to choose non-primary care specialties or to train in medical schools and residency programs in other states. To provide for increasing needs high-quality primary care residency programs are the need of the hour to fill vacancies left by retiring physicians.

Medicaid reimbursements – With Medicaid rates in California being 20% lower than the national Medicaid rate and among the lowest in the U.S, Californians face a severe shortage of physicians willing to cater to them, conversely, the California Legislature passed a budget in June reducing Medi-Cal physician payments by 10 %, among other reductions.  This could provide further incentive for students to choose specialties other than primary care. Patient access to care could be hampered as well if practicing physicians opt out of the Medi-Cal program because of the cuts. The state legislature and family physicians need to work together to remedy reimbursement issues.

California family physicians need a coordinated effort of various entities to remedy this shortage of primary care physicians. In this scenario where primary care physicians need to tackle an increased number of patients and cater to shortage issues, physicians may be short of time to give complete justice to their reimbursement strategy and medical billing and coding practices which hampers a steady flow of revenue for smooth running of their practice. Medical billers and coders can not only efficiently interact with insurance providers and increase claims generation but also keep up with healthcare IT reforms and comply with HIPAA and other guidelines.