title: The impact of managed care on the mix of vulnerable populations served by community health centers.
abstract: This article examined the impact of managed care involvement on vulnerable populations served by community health centers (CHCs), while controlling for center rural-urban location and size, and found that centers involved in managed care have served a significantly smaller proportion of uninsured patients but a higher proportion of Medicaid users than those not involved in managed care. The results suggest that the increase in Medicaid managed care patients may lead to a reduced capacity to care for the uninsured, thus hampering CHCs from expanding access to health care for the medically indigent.
authors.affiliation: Department of Health Policy and Management, School of Public Health and Hygiene, Johns Hopkins Primary Care Policy Center for the Underserved, The Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: L
authors.initials: L
authors.lastname: Shi
authors.forename: R M
authors.initials: RM
authors.lastname: Politzer
authors.forename: J
authors.initials: J
authors.lastname: Regan
authors.forename: D
authors.initials: D
authors.lastname: Lewis-Idema
authors.forename: M
authors.initials: M
authors.lastname: Falik
mesh_terms: D000704:Analysis of Variance; D003151:Community Health Centers / Q000458:organization & administration / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000191:economics; D006703:Ill-Housed Persons / Q000706:statistics & numerical data*; D006801:Humans; D008329:Managed Care Programs / Q000191:economics / Q000706:statistics & numerical data*; D008484:Medicaid / Q000706:statistics & numerical data*; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D008913:Minority Groups / Q000706:statistics & numerical data; D011203:Poverty / Q000706:statistics & numerical data; D012051:Reimbursement Mechanisms; D013221:State Health Plans; D014481:United States; D014600:Utilization Review