The impact of medicaid managed care on community clinics in Sacramento County, California

Objectives. The purpose of this study was to determine the impact of county wide Medicaid managed care on service use at community clinics. Methods. Clinic use before and after introduction of Medicaid plans in one county was compared with that in a group of comparable counties without suc h plans. Results. There were significant declines of 40% to 45% in the volumes of Me dicaid clients, encounters, and revenues at clinics with the introduction o f Medicaid plans. Declines of 23% in uninsured clients and encounters did n ot differ significantly. Conclusions. The introduction of Medicaid managed care with multiple commer cial plans can have significant negative effects on nonprofit community cli nics.