Low-income Californians' experiences with health insurance and managed care.
California is rapidly implementing mandatory managed care for most of its Medicaid (Medi-Cal) beneficiaries. To assess the impact of this delivery system change, the authors analyzed a 1996 statewide population-based random-sample telephone survey of 3,563 adults between the ages of 18 and 64. Respondents with Medi-Cal managed care and Medi-Cal fee-for-service rated access to care and quality of care significantly higher than uninsured respondents yet lower than low-income privately insured individuals. While the authors did not find a difference in health care access and quality among Medi-Cal managed care enrollees compared with Medi-Cal fee-for-service enrollees, they also did not find that managed care provided any observed advantages to Medi-Cal recipients.
Backus
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Immunology Case Registry, Center for Quality Management in HIV Care, VA Palo Alto Health Care System, 3801 Miranda Ave. #132, Palo Alto, CA 94304, USA.
Bindman
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D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D002140:California; D006297:Health Services Accessibility; D006801:Humans; D008329:Managed Care Programs / Q000592:standards*; D008484:Medicaid / Q000458:organization & administration*; D008875:Middle Aged; D011203:Poverty; D011314:Preventive Health Services / Q000706:statistics & numerical data; D011787:Quality of Health Care; D013221:State Health Plans; D014481:United States