Trends in physician participation in Medicaid. The California experience.
Physician participation rates in Medicaid vary widely across the country, and, overall, there has been a decline in recent years. We performed an evaluation in California of whether the expansion of Medicaid managed care and a physician payment increase were associated with an increase over time in the percentage of physicians caring for Medicaid patients. Surveys performed before and after these strategies were used did not reveal an increase over time in physicians' participation in California's Medicaid program. Budgetary constraints will force policy makers to confront the priorities of the Medicaid program, to question the policy objectives for physician participation in Medicaid, and to consider more far-reaching reforms in Medicaid and the overall health care system.
Bindman
Andrew B
AB
Departments of Medicine, Epidemiology, and Biostatistics, Primary Care Research Center, University of California-San Francisco, Box 1364, Pornassus Avenue, San Francisco, CA 94143, USA.
Yoon
Jean
J
Grumbach
Kevin
K
D001291:Attitude of Health Personnel; D002140:California; D004470:Economics, Medical; D019538:Health Care Surveys; D006280:Health Workforce; D006801:Humans; D008329:Managed Care Programs / Q000191:economics; D008484:Medicaid / Q000458:organization & administration*; D009937:Organizational Objectives; D010820:Physicians / Q000191:economics / Q000523:psychology / Q000600:supply & distribution*; D011320:Primary Health Care / Q000191:economics; D012044:Regression Analysis; D013038:Specialization; D013221:State Health Plans / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D014481:United States