Managed care and the treatment of skin disease, 1995. Continued growth and emerging dominance.

OBJECTIVE To document changes in type of financing for office-based visits for the treatment of common skin conditions and to dermatologists. DESIGN Data from a national survey of visits to office-based practitioners conducted by the National Center for Health Statistics were used. The stratified sampling technique permits estimation of the total number of office visits with specific characteristics in the United States. SETTING A national probability sample of visits to office-based practitioners occurring in 1995. SUBJECTS In 1995, 36,875 visits were sampled. Of these, 2121 were for common skin problems to any physician and 1886 were visits for any reason to dermatologists. MAIN OUTCOME MEASURES The distribution source of payment and presence of managed care arrangements for office visits for common skin problems and to dermatologists. INTERVENTION None. RESULTS In 1995, preferred provider and health maintenance organizations provided payment for 34% of all ambulatory care and 38% of office visits for common skin complaints. CONCLUSION Managed care is already the dominant mechanism of payment for the treatment of skin disease for many patient groups and in many areas of the country. Preferred provider organizations are much more likely to employ dermatologists to provide care of common skin problems than are health maintenance organizations. If the recent trends continue, by year 2000 most patients seen by dermatologists will be seen under the auspices of managed care systems.