Managed care has swept across the nation and has changed the health care industry from protective to competitive. Many financially weak health care providers merged or closed due to competitive pressure in the health care market. Enrollment in managed care plans is increasing over time. African- Americans, perceived as a high-risk, high-utilizing population due to the prevalence of costly diseases such as AIDS, low birth weight babies, tragic and expensive complications of violence, drugs and others, as well as high incidences of poverty and unemployment, are a vulnerable population in a competitive market. The main objective of this proposed project is to study the impact of managed care on access and utilization of health care services by African- Americans. Specifically, two related hypotheses will be tested. First, whether an increase in managed care penetration in the non-black population increases African-American enrollment in managed care plans or not. Second, whether African-Americans enrolled in managed care plans have a similar level of utilization of health care services as other African- Americans enrolled in non-managed care plans. These hypotheses win be tested using two regression equations (1) managed care penetration rate in the black population as a function of managed care penetration rate in the non-black population and other controls, (2) utilization of health care services by the African-American population as a function of insurance characteristics, health status and other controls. The data for the study win come from the National Health Interview Survey (NHIS), InterStudy and the Area Resource File (ARF) for the periods 1991 and 1996.
