Clinic Utilization
The clinic annual utilization data includes two types of clinics: primary care clinics and specialty clinics.
Primary care clinics, which include community and free clinics, offer a full range of primary care services to the uninsured and underinsured in their communities.
Specialty clinics include freestanding surgical, chronic dialysis, and rehabilitation clinics as well as alternative birth centers.
All licensed clinics must submit either an Annual Utilization Report of Primary Care Clinics or an Annual Utilization Report of Specialty Clinics with the Office every February 15 for the prior calendar year’s data. Beginning in 2002, clinics began submitting data to HCAI through an online reporting system. Once a report is submitted and meets edit criteria, it immediately becomes available to the public. After all individual clinic reports are received and approved, HCAI creates the Primary Care Clinic Data Set and the Specialty Clinic Data Set from which the following products are produced.
Available Data Products
Complete Data Set
Important note about preliminary and final utilization data:
Starting with the 2005 annual utilization data file, there will be two phases of data released. The preliminary data file released in the spring will contain data that has passed the prescribed set of fatal errors in the SIERA system and was therefore accepted into HCAI. The second data file released in the fall will be the desk-audited data and is considered the final version of the annual utilization data file. Please note that this preliminary set of data will only be live and downloadable on the web page up and to the point that the final version is released and then the preliminary data file will be replaced by the final data file. The pivot tables will be created in the fall for the desk audited data.
Primary Care Clinics
The complete Data Set of annual utilization data reported by primary care clinics contains basic clinic identification information including community services, clinic staffing data, and patient and staff language data; financial information including gross revenue, itemized write-offs by program, an income statement, and selected capital project items; and information on encounters by service, principal diagnosis (ICD codes), and procedure codes (CPT codes). The documentation, including report forms, is available for each reporting year.
Specialty Clinics
The complete Data Set of annual utilization data reported by specialty clinics contains basic information including the number of surgical operating rooms, number of surgeries performed, number of patients, number of encounters by service type, and major capital expenditures. The documentation, including report forms, is available for each reporting year.
Primary Care Clinic Pivot Profiles
Pivot profiles were developed using the annual utilization data files aggregated for each report year. It displays a variety of data elements captured in the Annual Utilization Report of Primary Care Clinics.
Trends
These products provide trend utilization information for primary care clinics in the form of tables and pivot tables. The primary care clinic trends include information on the number of clinics by type, the number of patients (by race, ethnicity, gender and age), the number of encounters by payer source; and revenues by payer source including the average revenue per encounter.
Primary Care Clinic Profile with Trends
- 2011-2015 (Excel)
- 2011-2015 (PDF)
- Trend Glossary
Trend Reports
*Due to changes in the reporting system for utilization data to HCAI beginning in 2002, earlier trends may not be directly comparable.
- 2003-2007
- 2003-2006
- 1991-2000
Please contact SIERA-Utilization Support to request for the reports listed above.
These pivot table products contain specialty clinic trend data, including the number of clinics and various utilization and financial information. Trends are separated by facility type: Surgical; Chronic Dialysis; and a third file that includes Alternate Birthing Centers (ABC), Psychology Clinics and Rehabilitation Clinics (separated by tabs).
- Alternative Birthing Center(ABC)/Psychology/Rehabilitation Clinics Trend Report, 2003-2007
- Dialysis Clinic Trend Report, 2003-2007
- Surgical Clinic Trend Report, 2003-2007
Please contact SIERA-Utilization Support to request for the reports listed above.
Additional Resources
SB 1511 (2024)
Senate Bill 1511 (Chaptered 492, Statutes of 2024), requires that every licensed clinic shall, file a verified report with the Department of Health Care Access and Information by March 15th every year, detailing specific information relating to the previous calendar year (Sections 1216, 128905, 128910, and 128920 of the Health and Safety Code). This legislation updates the annual due date for clinics to submit the Annual Utilization Reports, changing from February 15th to March 15th. Effective for the 2024 reporting year, the Annual Utilization Reports for Primary Care Clinics and Specialty Clinics are due on March 15, 2025, and annually on March 15th every proceeding year thereafter.
SB 779 (2023)
SB 779 (Chapter 505, Statutes of 2023) revises existing reporting requirements for primary care clinics and expands the requirements to intermittent clinics beginning in 2027. Additionally, this bill expands reporting data elements to include additional patient demographic information, Medi-Cal program or county indigent information, Medi-Cal federally qualified health center and rural health clinic (FQHC/RHC) prospective payment system (PPS) rate, labor data, and workforce development data. This bill also requires an organization that operates, conducts, owns, or maintains a primary care clinic or intermittent clinic, and its officers, to file specified reports with HCAI for every primary care clinic and intermittent clinic each year.
Upcoming Activities
The Primary Care Clinic Data Modernization Act Fact Sheet outlines implementation activities from January 2024 through December 2028 and ongoing.
Read the full SB 779 Primary Care Clinic Data Modernization Act Fact Sheet.
2024 – January to December
- Initiate program planning for implementation of new reporting requirements.
- Research for new and updated reporting requirements.
- Begin rulemaking process to further specify the revised reporting requirements.
2025 – January to December
- Review requirements for changes to current data infrastructure and related processes to collect new and updated data elements.
- Modify existing data infrastructure to collect new and updated data elements.
- Conduct data submitter engagement and technical assistance.
2026 – January to December
- Develop data submission resource documentation.
- Develop program data de-identification processes and guidance for technical assistance.
- Complete rulemaking process to further specify the revised reporting requirements.
2027 – January to December
- Regulations become effective.
- Complete modification of data infrastructure to collect new and updated data elements.
- Perform outreach and assistance to data submitters to prepare for first year of data collection.
2028 – January to December
- Collect and review reports. The expanded reports for calendar year 2027 are due by February 15, 2028.
- Publish list of clinics that fail to file a timely report.
- Review of data for completeness, consistency, and compliance with de-identification requirements.
- Perform statistical de-identification tasks.
- Publish the new and revised reports to the HCAI website.
Ongoing
- Continue to collect and publish clinic reports based on the revised requirements.
Contact Us
Clinics Utilization
For assistance with Primary Care and Specialty Clinic Utilization data, contact us at utilization@hcai.ca.gov.
SIERA Support
- Support Line: (916) 326-3854
Mailing Address
Department of Health Care Access and Information
Information Services Division
Utilization And Disclosure Reporting Section
2020 West El Camino Avenue, Suite 1100
Sacramento, CA 95833-6213