KEY FINDING: PRIMARY CARE Most members are connected to primary care, but barriers can make it challenging to receive timely care.
Access to regular medical care is important as it can lead to better health outcomes. Access to care includes having insurance coverage, having a location where one can receive regular preventive services (medical home) and finding a trusted health care provider.15 Barriers to accessing care, such as lack of insurance coverage, high costs of care, lack of available services or lack of culturally competent services, can lead to delays in receiving needed care, lack of preventive care, financial burden or preventable hospitalizations.16
Most members are connected to care, although barriers still exist
CalOptima works with medical groups, health networks, hospitals, pharmacies and more than 7,000 physicians. The majority of CalOptima members reported that they have at least one person they think of as their doctor (Exhibit 30). Based on the weighted CalOptima population estimate, nearly 83 percent of members have at least one person as their doctor (n=5,749), Farsi speakers had the highest percentage of members who have a doctor (94.5 percent) and Arabic speakers have the smallest percentage of members who have a doctor (82.4 percent) (Exhibit 30). When looking at this by age group, only 77 percent of adults age 18–64 have at least one person they think of as their doctor compared with more than 85 percent for all other age groups. The implementation of the Affordable Care Act increased membership among people 18–64 years old. It is possible that these members are still getting used to having health insurance so they have not fully utilized the coverage to see a primary care doctor.
46 | Key Findings: Primary Care
