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

C C Korenbrot, G Miller and J Greene

Institute for Health Policy Studies, University of California, San Francisco 94143-0936, USA. ckoren@itsa.ucsf.edu

OBJECTIVES: The purpose of this study was to determine the impact of countywide Medicaid managed care on service use at community clinics. METHODS: 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. RESULTS: 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. CONCLUSIONS: The introduction of Medicaid managed care with multiple commercial plans can have significant negative effects on nonprofit community clinics.