Managed care and the treatment of skin disease, 1995. Continued growth and emerging dominance.
OBJECTIVE
To document changes in type of financing for office-based visits for the treatment of common skin conditions and to dermatologists.


METHODS
Data from a national survey of visits to office-based practitioners conducted by the National Center for Health Statistics were used. The stratified sampling technique permits estimation of the total number of office visits with specific characteristics in the United States.


METHODS
A national probability sample of visits to office-based practitioners occurring in 1995.


METHODS
In 1995, 36,875 visits were sampled. Of these, 2121 were for common skin problems to any physician and 1886 were visits for any reason to dermatologists.


METHODS
The distribution source of payment and presence of managed care arrangements for office visits for common skin problems and to dermatologists.


METHODS
None.


RESULTS
In 1995, preferred provider and health maintenance organizations provided payment for 34% of all ambulatory care and 38% of office visits for common skin complaints.


CONCLUSIONS
Managed care is already the dominant mechanism of payment for the treatment of skin disease for many patient groups and in many areas of the country. Preferred provider organizations are much more likely to employ dermatologists to provide care of common skin problems than are health maintenance organizations. If the recent trends continue, by year 2000 most patients seen by dermatologists will be seen under the auspices of managed care systems.
Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, MA, USA. rstern@bidmc.harvard.edu
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Stern
D003880:Dermatology / Q000191:economics* / Q000706:statistics & numerical data* / Q000639:trends; D019538:Health Care Surveys; D006279:Health Maintenance Organizations / Q000706:statistics & numerical data*; D006801:Humans; D007357:Insurance, Physician Services / Q000706:statistics & numerical data; D008484:Medicaid / Q000706:statistics & numerical data; D006278:Medicare / Q000706:statistics & numerical data; D009819:Office Visits / Q000191:economics / Q000706:statistics & numerical data*; D011243:Preferred Provider Organizations / Q000706:statistics & numerical data*; D012871:Skin Diseases / Q000175:diagnosis; D014481:United States