Municipal Health Services Program: Improving Access While Controlling Costs

摘要

Under the Municipal Health Services Program (MHSP), five city governments created networks of primary care clinics with a goal to serve populations with poor access to medical care who tended to receive fragmented care in public hospitals and clinics. The clinics were to provide care at lower cost than the population's alternative sources of care. Medicare and Medicaid Waivers were also provided. The evaluation indicates that MHSP did reach most but not all of the targeted groups. MHSP successfully replaced some outpatient departments and emergency room services. However, it failed to realize some of the program goals of continuity and high patient satisfaction. Per capita costs of medical care for MHSP users were no more than for others, but not significantly less. However, for Medicare-eligible MSHP users, costs were significantly less.