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CMA responds to UCSF universal access report

March 14, 2018

The University of California, San Francisco recently released a report commissioned by the California State Assembly that aims to assist policymakers in providing recommendations for a sustainable health care system to achieve universal access in California. 


The report highlights that any successful path to universal health care must include measures to improve access to care by expanding Medi-Cal coverage for income eligible undocumented adults, increasing Medi-Cal payment rates and overcoming workforce shortages to meet the needs of rural and underserved communities. The report also found that any plan that does not address the issues of physician workforce and increasing Medi-Cal payment rates will ultimately fail to achieve the goal of universal access.


“Today’s report illustrates that despite the progress California has made in increasing the number of individuals with reported health insurance coverage, there are still significant barriers to achieving actual access to universal health care in California,” said California Medical Association (CMA) President Theodore M. Mazer, M.D. “We agree that to improve patient access to care, we must overcome the physician shortages communities are facing and increase Medi-Cal reimbursement rates, which are amongst the lowest in the country. CMA remains committed to working on comprehensive and realistic solutions that achieve universal access.”


Below are some highlighted quotations of the report:


  • “Administrative burdens have increased with the growing availability of electronic health records and is a source for frustration for patients as well as providers.” (Page 14)

  • “[T]he substantially lower prices paid by Medi-Cal have contributed to beneficiaries experiencing barriers to care and have inhibited the achievement of one of the original goals of the Medicaid program – namely, the mainstreaming of care for low income people into the same care settings as patients with other forms of coverage.” (Page 17)

  • “Even if California were to expand health plan competition through a public option in the individual market, additional steps would be needed to overcome physician workforce shortages in underserved areas.” (Page 23)

  • “To overcome workforce shortages California needs a comprehensive strategy, utilizing incentives to overcome the market forces that discourage physicians and other clinicians from specializing in primary care and practicing in underserved areas. Such an approach could include incentives (1) to ensure that the physician training pipeline includes individuals who are interested and prepared for these roles, (2) to reduce the financial and practice barriers for individuals to enter in these roles, and (3) through physician payment policies which can sustain them in these roles over time.” (Page 23)

  • “California should consider additional investments in each of these areas to address access barriers in underserved areas, but the most glaring shortcoming is in its Medi-Cal physician payment policy. Medi-Cal is the most significant payer in underserved communities, especially in rural areas where Medi-Cal is an even more prevalent payer than in urban areas.” (Page 24)

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