Community-Based Primary Care Centers Affected by Medicaid Clients Moving into Managed Care

During 1997 and 1998, researchers at the University of Washington Institute for Public Policy and Management assessed the needs of community-based primary care centers to participate successfully in managed care.

The research team interviewed individuals knowledgeable in community health centers and/or managed care, reviewed related literature, and surveyed activities in this area by other charitable foundations.

Key Findings

  • A spectrum of public policy and market-driven changes in the health care environment are having a profound effect on most health centers.

  • Prior expansions in Medicaid beneficiaries, combined with the advent of cost-based reimbursement through the Rural Health Clinics (RHCs) and the Federally Qualified Health Centers (FQHC) Program, increased health center reliance on Medicaid revenues.

  • In 1996, there was a 9.5 percent increase in uninsured clients at federally assisted Community and Migrant Health Centers, while total clients remained relatively unchanged (.05 percent increase).

  • The real impact of the rapid transition to Medicaid managed care on health centers was found to be extremely varied and largely dependent on location.

Key Recommendations

  • To address health center needs, the report recommended five categories of projects for funding:

    • National demonstration projects.
    • Policy analysis projects.
    • Special studies.
    • Short-term projects.
    • Public information projects.