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Related Experiment Videos

No exodus: physicians and managed care networks.

Ann S O'Malley, James D Reschovsky

    Tracking Report
    |May 12, 2006
    PubMed
    Summary

    The percentage of U.S. physicians opting out of managed care plans increased significantly between 2000-01 and 2004-05. This trend may lead to higher patient out-of-pocket costs and reduced physician access.

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    Area of Science:

    • Health Services Research
    • Physician Economics
    • Managed Care Policy

    Background:

    • Managed care plans significantly influence healthcare delivery and patient access in the U.S.
    • Physician participation in managed care networks has been relatively stable since the late 1990s.
    • Understanding trends in physician contracting is crucial for assessing healthcare system dynamics.

    Purpose of the Study:

    • To analyze the recent trends in the percentage of U.S. physicians not contracting with managed care plans.
    • To identify physician and practice characteristics associated with opting out of managed care.
    • To explore community-level variations in physician managed care participation.

    Main Methods:

    • Utilized national study data from the Center for Studying Health System Change (HSC).
    • Analyzed physician contracting status between 2000-01 and 2004-05.
    • Compared characteristics of physicians with and without managed care contracts.

    Main Results:

    • The percentage of U.S. physicians without managed care contracts rose from 9.2% in 2000-01 to 11.5% in 2004-05.
    • This increase was observed across various specialties and practice types.
    • Physicians without contracts were more likely to be long-practicing, part-time, non-board-certified, in small practices, or located in the western U.S.

    Conclusions:

    • A statistically significant increase in physicians not contracting with managed care plans was observed.
    • This trend may indicate a shift towards increased patient out-of-pocket expenses and potentially reduced access to care.
    • Local market conditions appear to play a role in physicians' decisions regarding managed care contracts.

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