title: Readiness for Medicaid managed care reform initiatives: a profile of rural family physicians.
abstract: Medicaid managed care is now an important factor in the financing of rural health care delivery. The participation of rural family physicians in Medicaid managed care is vital for the rural poor to access health services. This study examined 855 family physicians practicing in nonmetropolitan counties across the United States to determine their readiness to participate in Medicaid managed care. Physicians were asked about their experience with prepaid programs and the factors that would influence their participation in such a program. A shortage of health care providers and low reimbursement rates were most frequently cited as barriers to successful implementation. Physicians who had participated in prepaid programs in the past but were no longer participating had the most negative opinions about the potential for Medicaid managed care programs to enhance care for the poor in their communities. Overall, physicians reported potential for the program to improve access and quality of care, but they also expressed reservations about the financial and administrative effects on their practices. These results reveal that negative attitudes were associated with prepaid programs that failed to meet expectations, but physicians also expressed an optimism about the potential to serve the poor within a managed care model.
authors.affiliation: State University of New York Office of Rural Health, Erie County Medical Center, Buffalo 14215, USA.
authors.forename: P A
authors.initials: PA
authors.lastname: James
authors.forename: T M
authors.initials: TM
authors.lastname: Cowan
authors.forename: M K
authors.initials: MK
authors.lastname: Bliss
authors.forename: R P
authors.initials: RP
authors.lastname: Graham
authors.forename: T C
authors.initials: TC
authors.lastname: Rosenthal
mesh_terms: D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D005163:Factor Analysis, Statistical; D018166:Health Care Reform; D006297:Health Services Accessibility; D006801:Humans; D008329:Managed Care Programs; D008484:Medicaid; D010821:Physicians, Family / Q000523:psychology*; D011216:Practice Management, Medical; D011787:Quality of Health Care; D019035:Rural Health Services; D011795:Surveys and Questionnaires; D014481:United States