Impact and Consequences of Changes in Health Care Coverage Provided by the United Mine Workers of America Health and Retirement Funds in West Virginia Primary Care and Multi-Specialty Clinics Having Extensive Miner Caseloads. (Executive Summary)

摘要

This project examined the impact and consequences of changes in UMWA health benefits in 14 primary and multi-specialty care clinics in West Virginia, including a few Section 330 projects, whose caseloads were more than 30 percent Funds' beneficiaries as of July 1976. The findings reveal that: a) there were large fluctuations in utilization over the study period with none of the clinics returning to prestrike levels of utilization; b) the clinics experienced a steady decline, as much as 36 percent, in physician staff without recovery in numbers as well as a cutback through layoffs of salaried staff; c) the scope and mix of services were essentially maintained; and d) the clinics' management contingency plans to deal with the cutback in Funds included the use of reserves, a reduction in non-reimbursable services, staff and hours, and application for emergency deficit funding from public and private organizations. Further analysis indicated that Section 330-sponsored programs (Rural Health Initiative) continued to provide support for a broad scope of comprehensive health care services, and also experienced a lower rate of attrition of physicians and patients in comparisons with the other clinics studied.