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首页> 外文期刊>Medical care >The Impact of Medicaid Managed Care on Primary Care Physician Participation in Medicaid.
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The Impact of Medicaid Managed Care on Primary Care Physician Participation in Medicaid.

机译：医疗补助管理式护理对医疗补助中基层医疗医生参与的影响。

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OBJECTIVES:: Medicaid managed care has been touted as an important vehicle for increasing physician participation in Medicaid. Although there is anecdotal evidence that the opportunity to participate in Medicaid via managed care increases physician participation, no empirical study has validated the claim. This study explores the relationship between Medicaid managed care penetration at the county-level and the likelihood that a physician practicing in that county will participate in Medicaid. RESEARCH DESIGN:: We used 3 waves of a large, nationally representative sample of primary care physicians from the Community Tracking Study followed across time (1996-2001) to estimate the impact of changing Medicaid managed care penetration levels on physician participation in the program. County-level Medicaid managed care penetration rates were collected directly from state Medicaid agencies for the study. FINDINGS:: In cross-sectional bivariate and multivariate analyses, Medicaid managed care penetration is significantly associated with physician participation in Medicaid; however, the relationship is nonmonotonic, of small magnitude and generally not in the anticipated direction. Our analyses indicate that a 10 percentage point increase in managed care penetration would reduce the likelihood that physicians participate in Medicaid on average by 2.9 percentage points. Although commercial MCO penetration exhibited a small positive, linear relationship with physician participation, this was not sufficient to offset the effects of Medicaid-dominant MCO penetration. Panel data analysis supported these findings. CONCLUSIONS:: This study failed to find that increases in Medicaid managed care lead to increased primary care physician participation in Medicaid during the period 1996-2001.
机译：目的：医疗补助管理被吹捧为增加医生参与医疗补助的重要手段。尽管有轶事证据表明通过管理式医疗参与Medicaid的机会增加了医师的参与度，但尚无经验研究证实该说法。这项研究探讨了县级医疗补助管理式医疗渗透率与在该县执业的医生参加医疗补助的可能性之间的关系。研究设计：我们使用了来自社区追踪研究的3个大样本，全国范围内具有代表性的初级保健医生样本，这些样本随时间推移（1996-2001年）进行了评估，以评估不断变化的医疗补助管理的护理渗透水平对该计划的医生参与的影响。直接从州医疗补助机构收集县级医疗补助管理的护理普及率以进行研究。结果：在横断面双变量和多变量分析中，医疗补助管理下的医疗渗透率与医生参与医疗补助显着相关。但是，该关系是非单调的，幅度很小，通常不在预期的方向上。我们的分析表明，管理式医疗渗透率提高10个百分点将使医生平均参与Medicaid的可能性降低2.9个百分点。尽管商业MCO渗透与医生的参与表现出小的正线性关系，但这不足以抵消以Medicaid为主的MCO渗透的影响。小组数据分析支持了这些发现。结论：该研究未能发现在1996年至2001年期间，医疗补助管理式护理的增加导致基层医疗医生对医疗补助的参与增加。

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