Impact of managed MediCal on California family practice programs.
BACKGROUND
An important source of patients for California's family practice program is MediCal. During the past 5 years, MediCal has established a variety of capitated managed care plans.


OBJECTIVE
To assess the impact of California's managed MediCal program on the state's 38 family practice training programs.


METHODS
A cross-sectional, retrospective descriptive survey.


METHODS
A 3-page, 11-question survey was developed by family practice residency directors and staff from the California Academy of Family Physicians, San Francisco. The 38 family practice programs in existence in California in September 1997 were stratified by type of managed MediCal in their county and by type of sponsoring institution--university, county, community based, staff-model health maintenance organization, or managed care system.


RESULTS
Of the 38 family practice programs, 27 responded; 19 of 27 programs participated in managed MediCal. The total number of family health center patients, and the percentage of MediCal patients (48%-60%) at family practice programs was similar when stratified by programs with and without managed MediCal and by type of sponsorship. Most programs reported that they were able to compete effectively, although most also reported increased administrative, nursing, and front office costs. Managed MediCal patients were directly assigned to residents in only 3 of 19 programs.


CONCLUSIONS
The introduction of managed MediCal has not adversely affected the number of patients cared for in California's family practice programs. Continued vigilance regarding California family practice programs' involvement in managed MediCal, including collection of accurate data on the number of MediCal patients and the financial and educational implications for California's family practice programs, is warranted.
Zweifler
J A
JA
University of California at San Francisco-Fresno Family Practice Residency Program, 445 South Cedar Avenue, Fresno, CA 93702, USA. john.zweifler@ucsfresno.edu
D002140:California; D003430:Cross-Sectional Studies; D003625:Data Collection; D004501:Education, Medical / Q000458:organization & administration*; D005194:Family Practice / Q000193:education* / Q000639:trends; D006297:Health Services Accessibility; D006801:Humans; D008329:Managed Care Programs / Q000458:organization & administration*; D008484:Medicaid / Q000458:organization & administration*; D012189:Retrospective Studies; D013221:State Health Plans / Q000458:organization & administration*; D017664:Uncompensated Care; D014481:United States