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California State Auditor Logo COMMITMENT • INTEGRITY • LEADERSHIP

Department of Health Care Services
Millions of Children in Medi-Cal Are Not Receiving Preventive Health Services

Report Number: 2018-111


Statewide Preventive Care Utilization Rates

Because of a variety of problems, an annual average of 2.4 million children who were enrolled in Medi-Cal over the past five years have not received all of the preventive health services that the State has committed to provide to them. To explore this issue, we analyzed Department of Health Care Services' data for fiscal years 2013-14 through 2017-18. Using this data, we created the interactive graphics at the bottom of this page that allow users to explore preventive care utilization rates for children by location (county), health plan, age, language, and ethnicity for each fiscal year. As shown in the animation below, the statewide utilization rate has remained below 50 percent for the last five fiscal years.





As we discuss in Chapter 1 of the report, utilization rates are lower among certain age groups, with rates dropping from nearly 70 percent for children in their first year of life to 25 percent by the time they are two years old. A closer look at this data shows that low utilization rates among 2-year-olds occur all across the State regardless of geographic location. Utilization rates for 2-year-olds are also low for the majority of ethnicities and languages. However, 2-year-olds from Cantonese speaking families had a utilization rate of 55 percent.



As discussed in Chapter 2, cultural factors—including spoken language—appear to impact utilization rates. For instance, we noted a disparity of over 30 percent in utilization rates between Cantonese and Russian speakers in fiscal year 2016-17. The data shows that, on average, this discrepancy stayed relatively constant throughout all five fiscal years we reviewed. In addition, Cantonese speakers had—for the most part—higher utilization rates regardless of their location in the State.



Use the interactive graphics below to explore preventive care utilization rates for various populations of children throughout the State. Click the 'View By Health Plan' button to display this data by health plan instead of by county.




Accessible Content

Source: Analysis of DHCS's Management Information System/Decision Support System data.

Notes: Fiscal year 2017-18 data may be incomplete due to a delay in DHCS receiving the data.
To maintain the confidentiality of small groups of children, we redacted groups of 10 or less children from the above graphics.


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