Bindman Andrew B, Yoon Jean, Grumbach Kevin
Departments of Medicine, Epidemiology, and Biostatistics, Primary Care Research Center, University of California-San Francisco, Box 1364, Pornassus Avenue, San Francisco, CA 94143, USA.
J Ambul Care Manage. 2003 Oct-Dec;26(4):334-43. doi: 10.1097/00004479-200310000-00007.
Physician participation rates in Medicaid vary widely across the country, and, overall, there has been a decline in recent years. We performed an evaluation in California of whether the expansion of Medicaid managed care and a physician payment increase were associated with an increase over time in the percentage of physicians caring for Medicaid patients. Surveys performed before and after these strategies were used did not reveal an increase over time in physicians' participation in California's Medicaid program. Budgetary constraints will force policy makers to confront the priorities of the Medicaid program, to question the policy objectives for physician participation in Medicaid, and to consider more far-reaching reforms in Medicaid and the overall health care system.
医疗补助计划中医生的参与率在全国范围内差异很大，而且近年来总体呈下降趋势。我们在加利福尼亚州进行了一项评估，以确定医疗补助管理式医疗的扩张和医生薪酬的提高是否会随着时间的推移而使照顾医疗补助患者的医生比例增加。在采用这些策略前后进行的调查并未显示加利福尼亚州医疗补助计划中医生的参与率随时间有所增加。预算限制将迫使政策制定者面对医疗补助计划的优先事项，质疑医生参与医疗补助计划的政策目标，并考虑对医疗补助计划和整个医疗保健系统进行更深远的改革。
