WHAT DO MANAGED CARE PLANS DO TO AFFECT CARE - RESULTS FROM A SURVEY OF PHYSICIANS

Little is known about physicians' exposure to managed care techniques that affect clinical practice. In 1995, we conducted a survey of 2,003 U.S. physicians asking them about their share of patients subject to a variety of managed care techniques. Nationally, 24% of physicians re ceived some form of capitation payment for their patients. The two mos t widely used techniques were utilization review (UR) applied to an av erage of 59% of patients, and discounted fees, applied to an average o f 38% of patients. Although UR was common, ultimate denial rates of co verage were very low: at most 3% for the types of care studied. Use of managed care techniques varied more within states than between states . Conventional measures of HMO market penetration revealed little abou t how managed care affects physicians.