A Comparison of Ambulatory Services for Patients with Managed Care and Fee-for-Service Insurance

George E. Kikano, Clint W. Snyder, Edward J Callahan, Meredith A. Goodwin, Kurt C. Stange

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objectives: To determine whether family physicians provide different ambulatory care to patients with health insurance from managed care organization (MCO) versus fee-for-service (FFS) plans. Study Design: Multimethod cross-sectional observational study. Patients and Methods: A total of 4454 patients made office visits to 138 family physicians in northeastern Ohio. Direct observation with the Davis Observation Code and a structured checklist were used to assess the process of care. Patient satisfaction was measured with the Medical Outcomes Study 9-Item Visit Rating Form. Results: Among 1588 patients with MCO insurance and 876 with FFS insurance, no differences were noted in the number of visits per year, length of visits, percentage of visits for well care, or the percentage of visits in which medicines were prescribed in analyses controlling for patient mix. Visits by patients with MCO insurance were more likely to involve referrals to another physician than visits by patients with FFS insurance. Patient satisfaction and time use during visits were comparable for the 2 groups. Conclusions: Managed care insurance appears to increase involvement of the primary care provider in the referral process. However, in a healthcare market with moderate managed care penetration in which the same physicians see patients with different types of insurance, the process of care is affected little by type of insurance coverage.

Original languageEnglish (US)
Pages (from-to)181-186
Number of pages6
JournalAmerican Journal of Managed Care
Volume8
Issue number2
StatePublished - Feb 2002

Fingerprint

Fee-for-Service Plans
Managed Care Programs
Insurance
managed care
fee
insurance
family physician
organization
Family Physicians
Organizations
Patient Satisfaction
physician
insurance coverage
Referral and Consultation
Observation
Physicians
Office Visits
health insurance
cross-sectional study
Health Care Sector

ASJC Scopus subject areas

  • Nursing(all)
  • Medicine(all)
  • Health(social science)
  • Health Professions(all)

Cite this

A Comparison of Ambulatory Services for Patients with Managed Care and Fee-for-Service Insurance. / Kikano, George E.; Snyder, Clint W.; Callahan, Edward J; Goodwin, Meredith A.; Stange, Kurt C.

In: American Journal of Managed Care, Vol. 8, No. 2, 02.2002, p. 181-186.

Research output: Contribution to journalArticle

Kikano, George E. ; Snyder, Clint W. ; Callahan, Edward J ; Goodwin, Meredith A. ; Stange, Kurt C. / A Comparison of Ambulatory Services for Patients with Managed Care and Fee-for-Service Insurance. In: American Journal of Managed Care. 2002 ; Vol. 8, No. 2. pp. 181-186.
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