The impact of Medicaid managed care on community clinics in Sacramento County, California.

Abstract

The purpose of this study was to determine the impact of countywide Medicaid managed care on service use at community clinics. Clinic use before and after introduction of Medicaid plans in one county was compared with that in a group of comparable counties without such plans. There were significant declines of 40% to 45% in the volumes of Medicaid clients, encounters, and revenues at clinics with the introduction of Medicaid plans. Declines of 23% in uninsured clients and encounters did not differ significantly. The introduction of Medicaid managed care with multiple commercial plans can have significant negative effects on nonprofit community clinics.