PHYSICIAN PARTICIPATION IN MEDICAID MANAGED CARE

Medicaid programs throughout the United States are moving away from fe e-for-service medicine and increasingly towards managed care models in attempts to control rising health care costs. This study examines the participation of physicians in Arizona's prepaid, managed care Medica id program, the Arizona Health Care Cost Containment System (AHCCCS). In particular, it considers the reasons that physicians decide to part icipate in AHCCCS, and for participants, the possible impact of these reasons on whether they participate fully or on a limited basis. A mai l survey was sent to 300 primary care physicians in Arizona, of which 171 completed surveys were returned. Results suggested that physicians tend to participate because of reimbursement, approval of the 'type' of medicine that managed care allows them to practice, and their belie f in Medicaid-type programs. Physician attitudes toward the patients, while generally negative, do not keep them from participating in Medic aid. However, the type of patients in AHCCCS is related to physician s atisfaction with the AHCCCS health plans, as is reimbursement. The stu dy indicates differences in the reasons for participation between Ariz ona's physicians and those in fee-for-service Medicaid programs of oth er states.