The Center for the Health Professions
University of California, San Francisco
California Physicians 2002: Practice and Perceptions
December 2002
By Kevin Grumbach, MD, et al
Only 58% of patient care physicians in the state are accepting new patients if the patient has HMO insurance coverage. The percentage of specialists with HMO patients fell from 77% to 62% between 1998 and 2001. The rate of physician participation in private HMO plans is approaching the historically low rate of physician participation in Medi-Cal, the state’s insurance plan for low income Californians. A privately insured HMO patient in California now faces almost as much difficulty as a Medi-Cal patient in obtaining a new patient appointment with a new doctor. The problem of lack of availability of physicians in many regions of the state is largely due to physicians not accepting patients with certain types of health insurance (or without health insurance altogether) rather than due to an absolute shortage of physicians practicing in California.
http://futurehealth.ucsf.edu/pdf_files/Phass2.pdf
Comment: In a personal communication, Dr. Grumbach comments:
“Definitely looks like managed care is in the retreat in CA. Only problem is that I think a lot of docs are hoping to return to the mythical ‘good old days’, basically charging patients directly, rather than are looking forward to a universal system under public administration. And the results from the Kaiser docs are interesting, suggesting to me that Kaiser Permanente has actually won over its physician staff with a model of managed care that seems to be more genuinely committed to quality of care and a strong culture of physician led group practice.”