A new report from the California Health Care Foundation (CHCF) says that while “insurance coverage and financial stability” have greatly improved in the Fresno area, health care “capacity and access challenges” have also grown.

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“While the Fresno region’s largely agricultural economy has grown, it continues to be one of the poorest areas in California,” the report stated. “Many who were previously uninsured were able to enroll in Medi-Cal under the Affordable Care Act (ACA). This helped bring financial stability to the region’s health care sector but also compounded existing provider capacity constraints and access challenges.”

Other key findings from the CHCF report include:

            •          Medi-Cal enrollment has grown, now covering 41 percent of the population in the region compared to 27 percent for California as a whole, since the January 2014 ACA coverage expansions.

            •          The growth in insurance coverage exceeded expectations of providers and Medi-Cal managed care plans alike, leading to capacity challenges.

            •          Rural Health Clinics (RHCs) continue to grow, exacerbating competitive tensions with some Federally Qualified Health Centers (FQHCs).

            •          With the gains in Medi-Cal coverage and additional financial subsidies, the major hospitals and community health centers have generally experienced improvements in financial status.

            •          In a notable shift from previous rounds of this study, physicians in Fresno County have started to consolidate into larger, more integrated medical groups.

            •          Providers are taking on more risk in a market that has historically been almost exclusively fee-for-service.

Over the next several months, CHCF will be updating a series of issue briefs that examine the health care markets in six regions of California: Fresno, Los Angeles, Riverside/San Bernardino, Sacramento, San Diego and the San Francisco Bay Area.

These issue briefs highlight the state’s changing health care systems following the implementation of the ACA. The briefs are published as part of the CHCF’s California Health Care Almanac, an online clearinghouse for key data and analyses examining California’s medical system.