Medicaid patients' use of HMO services

In October 1984 the state Department of Health and Social Services established the Preferred Health Maintenance Organization (HMO) Enrollment Initiative, a mandatory HMO plan for Medicaid-Aid to Families with Dependent Children (AFDC) recipients residing in Dane and Milwaukee counties. This study examines the effect of the plan over two years on a family practice residency center that contracted with the state to provide primary care for 2,500 medical assistance recipients. Data showed that visits by Medicaid patients increased from 1.1 per person per year in 1982 to 3.5 in 1986 and that the percent of visits by these patients compared to total visits to the center increased from 20.8% in 1982 to 56% in 1986. This increased use by Medicaid patients was accompanied by a decline in visits by fee-for services patients. The potential effects on patient care and resident education are discussed.