摘要:OBJECTIVES: The purpose of this study was to determine the impact of countywide Medicaid managed care on service use at community clinics. METHODS: Clinic use before and after introduction of Medicaid plans in one county was compared with that in a group of comparable counties without such plans. RESULTS: There were significant declines of 40% to 45% in the volumes of Medicaid clients, encounters, and revenues at clinics with the introduction of Medicaid plans. Declines of 23% in uninsured clients and encounters did not differ significantly. CONCLUSIONS: The introduction of Medicaid managed care with multiple commercial plans can have significant negative effects on nonprofit community clinics.