Medicaid managed care's impact on safety-net clinics in California

A growing percentage of Medicaid patients are receiving medical care within a managed care system. This policy change has raised concerns about whether safety-net providers can maintain their share of Medi-Cal (California Medicaid) patients. From 1995 to 1997 several of California's counties im...

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Bibliographic Details
Published in:Health Affairs 2000-01, Vol.19 (1), p.194-202
Main Authors: Bindman, A B, Grumbach, K, Bernheim, S, Vranizan, K, Cousineau, M
Format: Article
Language:English
Subjects:
Ambulatory Care Facilities - organization & administration
Beneficiaries
California
Clinics
Counties
Enrollments
Fee-for-Service Plans - organization & administration
Government programs
Health care
Health care access
Health care policy
Health facilities
Health insurance
Health maintenance organizations
Health Policy
Health services
Health Services Research
HMOs
Humans
Indigent care
Low income groups
Managed care
Managed Care Programs - organization & administration
Medicaid
Medicaid - organization & administration
Medically Uninsured
Organizational Innovation
Patients
Penetration
Policy making
Poverty
Primary care
Primary Health Care - organization & administration
Public health
Reforms
Reimbursement
Safety
States
Statistical analysis
Surveys and Questionnaires
Uninsured people
United States
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Summary:A growing percentage of Medicaid patients are receiving medical care within a managed care system. This policy change has raised concerns about whether safety-net providers can maintain their share of Medi-Cal (California Medicaid) patients. From 1995 to 1997 several of California's counties implemented mandatory Medi-Cal managed care. The majority of California's safety-net primary care clinics experienced a decline in the percentage of their patients insured by Medi-Cal. However, after the overall decline in the number of Medi-Cal beneficiaries was controlled for, the increased penetration of Medi-Cal managed care in a county was not independently associated with a decline in clinics' share of Medi-Cal patients. Despite this fact, it may become increasingly difficult for clinics to maintain their current level of services with declining Medi-Cal enrollment and other anticipated reforms in their funding.
ISSN:0278-2715
1544-5208
DOI:10.1377/hlthaff.19.1.194