The Medicaid Opportunity: Solving for Access
California is at a breaking point. While millions are enrolled in Medi-Cal, the specialized care they need is increasingly out of reach. Our strategy transforms this crisis into a sustainable model for clinical excellence.
California psychiatry market study
County-level analysis of psychiatrist supply, Medi-Cal enrollment, and access gaps · Sources: NPI Registry, CHCF, DHCS (July 2024)
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All counties — sortable data
| County ▲ | Population ▲ | Psychiatrists ▲ | Per 100k ▲ | Medi-Cal enrolled ▲ | Medi-Cal % ▼ | MC per psychiatrist ▲ | Phase ▲ |
|---|---|---|---|---|---|---|---|
| Tulare | 476,356 | 23 | 4.8 | 300,659 | 63.1% | 13,072 | 2 |
| Imperial | 181,060 | 8 | 4.4 | 100,782 | 55.7% | 12,598 | 2 |
| Kern | 904,430 | 47 | 5.2 | 488,311 | 54% | 10,390 | 2 |
| Fresno | 1,014,946 | 88 | 8.7 | 546,102 | 53.8% | 6,206 | 2 |
| Lake | 65,908 | 3 | 4.6 | 35,417 | 53.7% | 11,806 | 2 |
| Merced | 286,149 | 14 | 4.9 | 153,747 | 53.7% | 10,982 | 2 |
| Madera | 159,786 | 6 | 3.8 | 83,961 | 52.5% | 13,994 | 2 |
| Glenn | 27,739 | 1 | 3.6 | 13,826 | 49.8% | 13,826 | 2 |
| Del Norte | 26,021 | 2 | 7.7 | 12,735 | 48.9% | 6,368 | 2 |
| Mendocino | 88,991 | 8 | 9 | 43,376 | 48.7% | 5,422 | 2 |
| Tehama | 64,440 | 2 | 3.1 | 31,380 | 48.7% | 15,690 | 2 |
| Colusa | 21,939 | 0 | 0 | 10,667 | 48.6% | — | 2 |
| Stanislaus | 544,160 | 27 | 5 | 260,447 | 47.9% | 9,646 | 2 |
| Sutter | 98,330 | 7 | 7.1 | 46,399 | 47.2% | 6,628 | 2 |
| Yuba | 84,086 | 3 | 3.6 | 38,921 | 46.3% | 12,974 | 2 |
| Monterey | 438,851 | 42 | 9.6 | 199,353 | 45.4% | 4,747 | 2 |
| San Bernardino | 2,180,503 | 120 | 5.5 | 987,371 | 45.3% | 8,228 | 2 |
| Humboldt | 134,408 | 16 | 11.9 | 60,695 | 45.2% | 3,793 | 1 |
| Modoc | 8,412 | 0 | 0 | 3,789 | 45% | — | 2 |
| Siskiyou | 42,665 | 3 | 7 | 19,139 | 44.9% | 6,380 | 2 |
| Kings | 153,709 | 5 | 3.3 | 68,004 | 44.2% | 13,601 | 2 |
| Butte | 205,517 | 21 | 10.2 | 86,866 | 42.3% | 4,136 | 1 |
| Riverside | 2,441,474 | 145 | 5.9 | 1,027,163 | 42.1% | 7,084 | 2 |
| Los Angeles | 9,784,023 | 2450 | 25 | 4,108,441 | 42% | 1,677 | 1 |
| Sacramento | 1,588,656 | 270 | 17 | 653,288 | 41.1% | 2,420 | 1 |
| San Joaquin | 787,365 | 38 | 4.8 | 323,476 | 41.1% | 8,513 | 2 |
| Santa Barbara | 446,729 | 58 | 13 | 179,873 | 40.3% | 3,101 | 1 |
| Shasta | 178,300 | 14 | 7.9 | 70,131 | 39.3% | 5,009 | 2 |
| Trinity | 15,823 | 0 | 0 | 5,896 | 37.3% | — | 2 |
| Mariposa | 16,780 | 1 | 6 | 6,066 | 36.2% | 6,066 | 2 |
| Lassen | 27,483 | 1 | 3.6 | 9,247 | 33.6% | 9,247 | 3 |
| San Benito | 65,022 | 2 | 3.1 | 21,597 | 33.2% | 10,799 | 3 |
| Solano | 446,932 | 31 | 6.9 | 148,129 | 33.1% | 4,778 | 3 |
| Ventura | 825,322 | 95 | 11.5 | 269,163 | 32.6% | 2,833 | 3 |
| Plumas | 18,709 | 1 | 5.3 | 6,056 | 32.4% | 6,056 | 3 |
| Orange | 3,142,387 | 550 | 17.5 | 1,015,634 | 32.3% | 1,847 | 3 |
| San Diego | 3,310,718 | 620 | 18.7 | 1,051,288 | 31.8% | 1,696 | 3 |
| Calaveras | 44,483 | 1 | 2.2 | 14,088 | 31.7% | 14,088 | 3 |
| Santa Cruz | 261,708 | 32 | 12.2 | 83,078 | 31.7% | 2,596 | 3 |
| Alameda | 1,654,334 | 289 | 17.5 | 502,349 | 30.4% | 1,738 | 1 |
| San Francisco | 850,147 | 450 | 52.9 | 254,723 | 30% | 566 | 1 |
| Sonoma | 478,459 | 68 | 14.2 | 143,432 | 30% | 2,109 | 3 |
| Inyo | 18,656 | 1 | 5.4 | 5,579 | 29.9% | 5,579 | 3 |
| Nevada | 99,875 | 12 | 12 | 29,757 | 29.8% | 2,480 | 3 |
| Contra Costa | 1,143,037 | 192 | 16.8 | 334,637 | 29.3% | 1,743 | 1 |
| Tuolumne | 53,458 | 4 | 7.5 | 15,556 | 29.1% | 3,889 | 3 |
| Yolo | 220,325 | 18 | 8.2 | 62,145 | 28.2% | 3,453 | 3 |
| Alpine | 1,163 | 0 | 0 | 323 | 27.8% | — | 3 |
| Napa | 133,989 | 22 | 16.4 | 36,365 | 27.1% | 1,653 | 3 |
| Sierra | 3,133 | 0 | 0 | 818 | 26.1% | — | 3 |
| Mono | 13,215 | 1 | 7.6 | 3,423 | 25.9% | 3,423 | 3 |
| San Luis Obispo | 280,437 | 30 | 10.7 | 69,066 | 24.6% | 2,302 | 3 |
| Santa Clara | 1,917,472 | 360 | 18.8 | 471,282 | 24.6% | 1,309 | 1 |
| Amador | 40,198 | 3 | 7.5 | 9,421 | 23.4% | 3,140 | 3 |
| San Mateo | 747,719 | 155 | 20.7 | 171,322 | 22.9% | 1,105 | 1 |
| El Dorado | 186,622 | 16 | 8.6 | 42,454 | 22.7% | 2,653 | 3 |
| Marin | 254,283 | 93 | 36.6 | 56,337 | 22.2% | 606 | 3 |
| Placer | 412,892 | 35 | 8.5 | 81,836 | 19.8% | 2,338 | 3 |
Our core thesis
The data is clear: network adequacy is not a recruitment problem; it's a delivery problem. We believe that by empowering clinicians to lead, we can solve the access gap that traditional models have ignored.
Clinician-led model
We empower psychiatrists to lead their own Professional Corporations (P.C.s). By removing administrative friction, we allow doctors to focus on what they do best: delivering high-quality patient care.
Clinical coaching
Go beyond simple supervision. Our model integrates active mentorship and peer-to-peer coaching to ensure clinical outcomes remain the primary metric of success in the Medicaid market.
Medicaid excellence
Medicaid is complex, but it shouldn't be a barrier. We've built the infrastructure to handle credentialing, billing, and compliance, making the "hardest" market the most rewarding.
The Value Proposition
For Doctors
- Total Autonomy: The freedom of private practice without the operational headaches.
- Clinical Support: Access to a network of peers and expert clinical coaching.
- Impact: The ability to serve the most vulnerable populations profitably and effectively.
For Health Plans
- Network Adequacy: Reliable, high-density provider networks in high-need counties.
- Quality Assurance: Predictable clinical outcomes backed by our leadership model.
- Turnkey Partnership: A single point of contact for complex behavioral health needs.
Long-term vision
Our roadmap starts with closing the gaps identified in this study. From the "Phase 1" markets in the Bay Area to the "Severe Shortage" zones in the Central Valley, we are building a blueprint for national scale.
Phase 1: Build
Leverage existing supply in urban hubs to create clinical centers of excellence.
Phase 2: Expand
Deploy our "Clinical Coaching" model to high-need, low-supply counties across California.
Phase 3: Scale
Export the California blueprint to Medicaid markets nationwide to solve the mental health crisis.