scholarly journals Selection and Exclusion of Primary Care Physicians by Managed Care Organizations

JAMA ◽  
1998 ◽  
Vol 279 (9) ◽  
pp. 675 ◽  
Author(s):  
Andrew B. Bindman
Keyword(s):  
Primary Care ◽  
Managed Care ◽  
Primary Care Physicians ◽  
Managed Care Organizations

scholarly journals Utilization of Services by Chronically Ill People in Managed Care and Indemnity Plans: Implications for Quality

2003 ◽  
Vol 40 (1) ◽  
pp. 57-70 ◽  
Author(s):  
Stephen M. Davidson ◽  
Harriet Davidson ◽  
Heidi Miracle-McMahill ◽  
J. Michael Oakes ◽  
Sybil Crawford ◽  
...  
Keyword(s):  
Primary Care ◽  
Managed Care ◽  
Chronic Conditions ◽  
Primary Care Physicians ◽  
Chronically Ill ◽  
Hospital Emergency Department ◽  
Hospital Emergency ◽  
Utilization Of Services ◽  
Managed Care Organizations

Because incentives for managed care organizations favor cost containment, concerns have been raised that quality of care has suffered, especially for chronically ill people. This study compares utilization rates of managed care and indemnity patients with three chronic conditions, using five years of claims records (1993–97) from private plans and Medicare in one market. Findings show that for all three conditions, managed care patients were more likely to see both primary care physicians and specialists within a year, but less likely to use a hospital emergency department or to be an inpatient. Assuming that patients with these illnesses should see a physician annually and that good primary care reduces the need for emergency and inpatient services, it appears that the patterns of care used by chronically ill managed care patients in this market do not reflect lower quality than that received by similar indemnity patients.

Caring for Patients Under Medicaid Mandatory Managed Care: Perspectives of Primary Care Physicians

2003 ◽  
Vol 13 (1) ◽  
pp. 37-56 ◽  
Author(s):  
Rosemary V. Chaudry ◽  
William P. Brandon ◽  
Carolyn R. Thompson ◽  
R. Stephen Clayton ◽  
Nancy B. Schoeps
Keyword(s):  
Primary Care ◽  
Managed Care ◽  
Primary Care Physicians

The Content of Report Cards: Do Primary Care Physicians and Managed Care Medical Directors Know What Health Plan Members Think Is Important?

1999 ◽  
Vol 25 (8) ◽  
pp. 422-433 ◽  
Author(s):  
Norbert Goldfield ◽  
Celia Larson ◽  
Douglas Roblin ◽  
David Siegal ◽  
John Eisenhandler ◽  
...  
Keyword(s):  
Primary Care ◽  
Managed Care ◽  
Health Plan ◽  
Primary Care Physicians ◽  
Report Cards ◽  
Medical Directors

Managed Care and the Expanding Scope of Primary Care Physicians' Duties: A Proposal to Redefine Explicitly the Standard of Care

1998 ◽  
Vol 26 (2) ◽  
pp. 100-112 ◽  
Author(s):  
Bernard Friedland
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Managed Care ◽  
Health Care System ◽  
Diagnostic Tests ◽  
Primary Care Physicians ◽  
Standard Of Care ◽  
Therapeutic Interventions ◽  
Utilization Review ◽  
Payment Methods

Managed care has brought wide-ranging changes to the health care system. Some of these changes have been well publicized. Among them are the financial pressures that have resulted in numerous mergers of health care institutions, the restriction on the ability of patients to select their physician of choice, and the ever diminishing number of days that patients are permitted to stay in the hospital. Individual physicians, too, have been affected. For example, they are under pressure to see more patients per unit time and to use fewer resources. Utilization review and payment methods may make them reluctant to undertake the full set of diagnostic tests and therapeutic interventions when they might otherwise have done so.

scholarly journals Specialists’ and primary care physicians’ participation in medicaid managed care

2001 ◽  
Vol 16 (12) ◽  
pp. 815-821 ◽  
Author(s):  
Lisa Backus ◽  
Dennis Osmond ◽  
Kevin Grumbach ◽  
Karen Vranizan ◽  
Lucy Phuong ◽  
...  
Keyword(s):  
Primary Care ◽  
Managed Care ◽  
Primary Care Physicians ◽  
Medicaid Managed Care
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