Pediatric and Adult Physician Networks in Affordable Care Act Marketplace Plans.
OBJECTIVES: To describe and compare pediatric and adult specialty physician networks in marketplace plans. METHODS: Data on physician networks, including physician specialty and address, in all 2014 individual marketplace silver plans were aggregated. Networks were quantified as the fraction of prov...
| Publicado en: | Pediatrics Vol. 139; no. 4; pp. 1 - 9 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
American Academy of Pediatrics
Apr2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=122348433&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 122348433 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00314005 PDT jtl: Pediatrics issn: 00314005 maglogo: N pubinfo: dt: Apr2017 vid: 139 iid: 4 pid: 1659 pub: American Academy of Pediatrics place: Elk Grove Village, Illinois artinfo: ui: 122348433 122348433 122348433 10.1542/peds.2016-3117 122348433 ppf: 1 ppct: 8 formats: tig: atl: Pediatric and Adult Physician Networks in Affordable Care Act Marketplace Plans. aug: au: Wong, Charlene A. Kan, Kristin Cidav, Zuleyha Nathenson, Robert Polsky, Daniel affil: Division of Adolescent Medicine, Department of Pediatrics, The Children's Hospital of Philadelphia sug: subj: Health Insurance Exchanges Specialties, Medical Health Services Accessibility Medical Practice Human Funding Source Resource Databases, Health Comparative Studies United States Insurance Carriers P-Value Data Analysis Software Descriptive Statistics Child Adult Insurance Coverage Hospitals, Pediatric Managed Competition Child: 6-12 years Adult: 19-44 years ab: OBJECTIVES: To describe and compare pediatric and adult specialty physician networks in marketplace plans. METHODS: Data on physician networks, including physician specialty and address, in all 2014 individual marketplace silver plans were aggregated. Networks were quantified as the fraction of providers in the underlying rating area within a state that participated in the network. Narrow networks included none available networks (ie, no providers available in the underlying area) and limited networks (ie, included <10% of the available providers in the underlying area). Proportions of narrow networks between pediatric and adult specialty providers were compared. RESULTS: Among the 1836 unique silver plan networks, the proportions of narrow networks were greater for pediatric (65.9%) than adult specialty (34.9%) networks (P < .001 for all specialties). Specialties with the highest proportion of narrow networks for children were infectious disease (77.4%) and nephrology (74.0%), and they were highest for adults in psychiatry (49.8%) and endocrinology (40.8%). A larger proportion of pediatric networks (43.8%) had no available specialists in the underlying area when compared with adult networks (10.4%) (P < .001 for all specialties). Among networks with available specialists in the underlying area, a higher proportion of pediatric (39.3%) than adult (27.3%) specialist networks were limited (P < .001 except psychiatry). CONCLUSIONS: Narrow networks were more prevalent among pediatric than adult specialists, because of both the sparseness of pediatric specialists and their exclusion from networks. Understanding narrow networks and marketplace network adequacy standards is a necessary beginning to monitor access to care for children and families. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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