title: The impact of Medicaid managed care on community clinics in Sacramento County, California.
abstract: OBJECTIVE
  The purpose of this study was to determine the impact of countywide Medicaid managed care on service use at community clinics.
  
  
  METHODS
  Clinic use before and after introduction of Medicaid plans in one county was compared with that in a group of comparable counties without such plans.
  
  
  RESULTS
  There were significant declines of 40% to 45% in the volumes of Medicaid clients, encounters, and revenues at clinics with the introduction of Medicaid plans. Declines of 23% in uninsured clients and encounters did not differ significantly.
  
  
  CONCLUSIONS
  The introduction of Medicaid managed care with multiple commercial plans can have significant negative effects on nonprofit community clinics.
authors.affiliation: Institute for Health Policy Studies, University of California, San Francisco 94143-0936, USA. ckoren@itsa.ucsf.edu
authors.forename: C C
authors.initials: CC
authors.lastname: Korenbrot
authors.forename: G
authors.initials: G
authors.lastname: Miller
authors.forename: J
authors.initials: J
authors.lastname: Greene
mesh_terms: D000704:Analysis of Variance; D002140:California; D003151:Community Health Centers / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D007182:Income / Q000706:statistics & numerical data / Q000639:trends; D007344:Insurance Claim Reporting / Q000706:statistics & numerical data / Q000639:trends; D008329:Managed Care Programs / Q000458:organization & administration*; D008484:Medicaid / Q000458:organization & administration*; D017057:Medically Uninsured / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D015397:Program Evaluation; D014481:United States