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Study shows impact of managed care on obstetrician-gynecologists and their patients

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November 13, 2001 Washington, DC In an article to be published in upcoming edition of the journal, Women's Health Issues, Emily Schifrin, MS, Jacobs Institute of Womens Health and colleagues report on the impact of managed care on obstetrician-gynecologists (ob-gyns), physicians who provide health care exclusively to women.  Of the 180 million Americans enrolled in managed care programs a majority are women. 

In the first study ever to specifically ask ob-gyns about their experiences with managed care, the authors report on an analysis of responses by 1,230 ob-gyns to the 1998 Survey of Fellows conducted by the American College of Obstetricians and Gynecologists. 

The survey found that 95% of ob-gyns participate in managed care plans, including 92% who participate in commercial managed care plans, 56% in Medicare managed care, and 50% in Medicaid managed care.  Two-thirds (67%) reported they are permitted to serve as a womans primary care provider; of these, 47% say they actually serve as a primary care provider.  Over half (55%) of ob-gyns reported that pregnant patients are permitted to see them for an unlimited number of visits without a referral.  Only 31% said that gynecologic patients have direct access for an unlimited number of visits.

Promptness of payment, followed by administrative workload and external review of clinical decisions were the greatest sources of dissatisfaction among ob-gyns in the survey.  Fifty percent reported that care they had recommended had been denied. 

The authors conclude that further research is needed on the impact of administrative burdens, restrictions on access to ob-gyns, and denials of coverage on womens receipt of timely and appropriate services.  They also suggest that managed care companies may want to investigate ways to improve physicians satisfaction levels, as doctors who terminate their contracts have a negative impact on continuity of care and patient satisfaction.

Womens Health Issues is the official publication of The Jacobs Institute of Womens Health, a nonprofit organization dedicated to advancing the knowledge, practice, and understanding of womens health by making America's health care system work better for women.  For the next few years, the Jacobs Institute is placing an emphasis on managed care, heart disease and menopause cutting edge issues that affect womens health and lives. 


NOTE: Review copies of this article are available to media from Steve Fitzer at 202/863-4989.