title: Medicaid managed care's impact on safety-net clinics in California.
abstract: 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.
authors.affiliation: University of California, San Francisco, USA.
authors.forename: A B
authors.initials: AB
authors.lastname: Bindman
authors.forename: K
authors.initials: K
authors.lastname: Grumbach
authors.forename: S
authors.initials: S
authors.lastname: Bernheim
authors.forename: K
authors.initials: K
authors.lastname: Vranizan
authors.forename: M
authors.initials: M
authors.lastname: Cousineau
mesh_terms: D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D002140:California; D018588:Fee-for-Service Plans / Q000458:organization & administration; D006291:Health Policy; D006302:Health Services Research; D006801:Humans; D008329:Managed Care Programs / Q000458:organization & administration*; D008484:Medicaid / Q000458:organization & administration*; D017057:Medically Uninsured; D009936:Organizational Innovation; D011203:Poverty; D011320:Primary Health Care / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D014481:United States