Access to In-Network Emergency Physicians and Emergency Departments Within Federally Qualified Health Plans in 2015.

Introduction: Under regulations established by the Affordable Care Act, insurance plans must meet minimum standards in order to be sold through the federal Marketplace. These standards to become a qualified health plan (QHP) include maintaining a provider network sufficient to assure access to servi...

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Publicado en:Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health Vol. 17; no. 1; pp. 18 - 22
Autores principales: Dorner, Stephen C., Camargo Jr., Carlos A., Schuur, Jeremiah D., Raja, Ali S.
Formato: research tables/charts Journal Article
Publicado: Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health Jan2016
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health
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        10.5811/westjem.2015.12.29188
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        atl: Access to In-Network Emergency Physicians and Emergency Departments Within Federally Qualified Health Plans in 2015.
      aug:
        au:
          Dorner, Stephen C.
          Camargo Jr., Carlos A.
          Schuur, Jeremiah D.
          Raja, Ali S.
        affil: Vanderbilt University School of Medicine, Department of Emergency Medicine, Nashville, Tennessee
      sug:
        subj:
          Physicians, Emergency
          Health Insurance Exchanges
          Health and Welfare Planning
          Emergency Medicine Standards
          Patient Protection and Affordable Care Act
          Emergency Service
          Snowball Sample
      ab: Introduction: Under regulations established by the Affordable Care Act, insurance plans must meet minimum standards in order to be sold through the federal Marketplace. These standards to become a qualified health plan (QHP) include maintaining a provider network sufficient to assure access to services. However, the complexity of emergency physician (EP) employment practices - in which the EPs frequently serve as independent contractors of emergency departments, independently establish insurance contracts, etc... - and regulations governing insurance repayment may hinder the application of network adequacy standards to emergency medicine. As such, we hypothesized the existence of QHPs without in-network access to EPs. The objective is to identify whether there are QHPs without in-network access to EPs using information available through the federal Marketplace and publicly available provider directories. Results: In a national sample of Marketplace plans, we found that one in five provider networks lacks identifiable in-network EPs. QHPs lacking EPs spanned nearly half (44%) of the 34 states using the federal Marketplace. Conclusion: Our data suggest that the present regulatory framework governing network adequacy is not generalizable to emergency care, representing a missed opportunity to protect patient access to in-network physicians. These findings and the current regulations governing insurance payment to EPs dis-incentivize the creation of adequate physician networks, incentivize the practice of balance billing, and shift the cost burden to patients.
      pubtype: Academic Journal
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        research
        tables/charts
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      ougenre: Article
    language: English
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