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Managed Care and Physicians' Provision of Charity Care Journal of the American Medical Association |
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Ability to Obtain Medical Care for the Uninsured Journal of the American Medical Association |
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A Changing Picture of Uncompensated Care Health Affairs |
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| March 1999 Research Report No. 03 |
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| Winter 1999/2000 Inquiry |
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Pressures on the Health Care Safety Net:
Implications for Access to Care for the Uninsured
April 1999
Health Services Research, vol.34, no.1 (April 1999): 255-270
Peter J. Cunningham
o examine the effects of managed care penetration and the rate of
uninsurance on low income people’s access to health care, as well as differences in access
between low income people with and without health insurance, the author used the Community
Tracking Study household survey as a source of data. Measures of managed care included
both overall and Medicaid managed care penetration in the community. There were three
measures of access to care: a usual source of care, any ambulatory care use and unmet
medical needs. The study also controlled for other individual and community
characteristics associated with access. The results showed that low income uninsured
people had less access to care in states with high Medicaid managed care penetration.
Differences in access to care between those with and those without health insurance is
greater in areas with high Medicaid managed care penetration. The author concluded that
efforts to lower health care costs may result in financial pressures that limit
subsidization of care to the medically indigent, especially for providers who depend
heavily on Medicaid revenue. Cunningham also found that higher uninsurance rates in a
community are associated with lower access for the uninsured.
Free access to this article is available at the Health Services Research Web site.
