Enrollees of Medi-Cal, California’s Medicaid program, receive their primary care from both Federally Qualified Health Centers (FQHCs) and non-FQHC providers. However, not much is known about how enrollees use these different providers. Using 2022 Medi-Cal data, the authors identified the types of providers delivering care to enrollees to inform efforts supporting primary care providers and the patients they serve.

Understanding California’s Safety Net

Identifying the Health Care Providers Delivering Primary Care to Medi-Cal Enrollees

Petra W. Rasmussen, Aaron Kofner, Joshua Eagan, Cheryl L. Damberg

ResearchPublished Sep 19, 2025

Nearly 14.5 million individuals are enrolled in California’s Medicaid program, better known as "Medi-Cal." Medi-Cal enrollees receive their primary care from both Federally Qualified Health Centers (FQHCs) and non-FQHC clinics and providers. However, not much is known about the extent to which subgroups of Medi-Cal enrollees use these different providers. Developing a better understanding of where different subgroups of Medi-Cal enrollees receive their primary care could inform efforts to improve support for primary care providers and the patients they serve. 

Using Medi-Cal data from 2022, RAND researchers identified and described the types of providers delivering primary care to Medi-Cal enrollees overall and by select patient characteristics, including race or ethnicity, age, geography, and levels of English-language proficiency. With these data, they were able to (1) identify the providers delivering primary care services to enrollees in FQHC and non-FQHC settings, (2) pinpoint key characteristics about these providers, (3) examine what percentage of providers deliver a high proportion of primary care visits to Medi-Cal enrollees, and (4) determine whether this percentage varies by Medi-Cal enrollee group and county. 

Key Findings

  • More than two-thirds of all primary care visits were with non-FQHC providers.
  • Younger Medi-Cal enrollees were more likely to receive their primary care from non-FQHC providers.
  • Nearly all providers that delivered primary care services to Medi-Cal enrollees provided some of those visits in non-FQHC settings.
  • Compared with FQHC providers, non-FQHC providers were more often located in Northern California, in metropolitan areas, and in smaller practices.
  • Non-FQHC providers, on average, served a smaller number of unique Medi-Cal patients compared with FQHC providers and provided fewer primary care visits on average compared with FQHC providers.
  • Solo and small practices accounted for more than 2.1 million non-FQHC primary care visits by Medi-Cal enrollees in 2022.
  • Small practices are particularly important to Medi-Cal enrollees who identify as Asian or Pacific Islanders.
  • Small practices accounted for a much larger share of non-FQHC primary care visits in four more-populous southern counties and two smaller northern counties.
  • A small percentage of providers deliver most of the primary care visits provided to Medi-Cal enrollees.
  • A particularly small percentage of National Provider Identifiers provide most of the primary care visits for Vietnamese, Chinese, and American Indian/Alaska Native enrollees.
  • Non-FQHC providers are more often in small practices.
  • The providers that deliver most of the care to Asian and Pacific Islander enrollees are more frequently operating in small practices.
  • There were substantial variations in the percentage of providers delivering 80 percent of primary care visits across counties.

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Rasmussen, Petra W., Aaron Kofner, Joshua Eagan, and Cheryl L. Damberg, Understanding California’s Safety Net: Identifying the Health Care Providers Delivering Primary Care to Medi-Cal Enrollees. Santa Monica, CA: RAND Corporation, 2025. https://www.rand.org/pubs/research_reports/RRA3844-1.html.
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This research was funded by the California Health Care Foundation and carried out within the Access and Delivery Program in RAND Health Care.

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