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pubmed-article:16322173pubmed:abstractTextBeginning in 1997 the Colorado Medicaid program de-emphasized managed care and shifted children from enrollment in a health maintenance organization (HMO), which required an enrollee to have an assigned primary care physician, to either the unassigned fee-for-service (UFFS) program in which the enrollee was not required to have a primary care physician (PCP) or to the primary care physician program (PCPP) in which the enrollee was required to select a participating PCP if one was available. The proportion of Medicaid enrollee-months in HMOs dropped from 75.4% in 1997 to 29% in 2003, whereas the proportion of enrollee-months in UFFS programs during this time period increased from 18.6% to 45.6%, and the proportion in the PCPP increased from 5.5% to 25.3%. This shift of children from HMO managed care to the UFFS program provided a natural experiment to assess the impact of not having an assigned PCP on pediatric primary care services.lld:pubmed
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pubmed-article:16322173pubmed:articleTitleImpact of a decline in Colorado Medicaid managed care enrollment on access and quality of preventive primary care services.lld:pubmed
pubmed-article:16322173pubmed:affiliationDepartment of Pediatrics, University of Colorado School of Medicine, Denver, Colorado, USA. berman.stephen@tchden.orglld:pubmed
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