Keith Elder, PhD¹, Sudha Xirasagar, PhD¹, and A. Nancy Miller, PHD². (1) Dept of Health Services Policy and Management, University of South Carolina, 800 Sumter Street, Columbia, SC 29208, 803-777-5041, kelder@gwm.sc.edu, (2) umbc, 1000 Hilltop Circle, Baltimore, MD 21250

The reasons managed care organizations provided for denials and terminations of physicians contracts contrasted with the physician’s beliefs on the genuineness of those reasons will be presented. A description of the reasons for discrimination from the physician perspective will also be presented. Earlier findings from this study revealed patient demographics were predictors for contract denials and terminations. Physicians who care for greater percentages of minority patients were more likely to have a contract denied or terminated compared to physicians who provide care for lower percentages of minority patients. This study was the first to our knowledge to examine physician selection within a competitive environment. In competitive markets, a higher rate of contract denial and termination might be expected for physicians whose patients require more medical resources than white patients. However, when market competition is accounted for, the differences still persist. Some other factors may be influencing the selection process, possibly discrimination. Strategy is important to all health care organizations, especially in competitive environments. Given that minority physicians provide care to more minority patients than white physicians, the strategic behavior of managed care organizations in regards to selecting physicians may compromise access to health care for minority patients. The target population for the survey was Maryland physicians from all specialties. The response rate was 53%, as 1,637 of the 3113 physicians who were mailed a survey returned the survey.

Learning Objectives:

• Participants will gain insight into the decision making of managed care organizations in competitive environments as it relates to physician contract denials and terminations.

Keywords: Managed Care,

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.