Relation Between Narrow Networks and Providers of Cancer Care.
Purpose Health insurers offer plans covering a narrow subset of providers in an attempt to lower premiums and compete for consumers. However, narrow networks may limit access to high-quality providers, particularly those caring for patients with cancer. Methods We examined provider networks offered...
| Publicado en: | Journal of Clinical Oncology Vol. 35; no. 27; pp. 3131 - 3137 |
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| Autores principales: | , , |
| Formato: | Journal Article |
| Publicado: |
American Society of Clinical Oncology
9/20/2017
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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=125180234&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 125180234 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0732183X 20D jtl: Journal of Clinical Oncology issn: 0732183X maglogo: N pubinfo: dt: 9/20/2017 vid: 35 iid: 27 pid: 26892 pub: American Society of Clinical Oncology place: Alexandria, Virginia artinfo: ui: 125180234 125180234 NLM28678667 10.1200/JCO.2017.73.2040 NLM28678667 125180234 ppf: 3131 ppct: 6 formats: tig: atl: Relation Between Narrow Networks and Providers of Cancer Care. aug: au: Yasaitis, Laura Bekelman, Justin E. Polsky, Daniel affil: University of Pennsylvania, Philadelphia, PA sug: subj: Neoplasms Therapy Health Services Accessibility Economics Insurance, Health Economics Cancer Care Facilities Economics Health Insurance Exchanges United States Economic Competition National Cancer Institute (U.S.) Data Collection Ferrans and Powers Quality of Life Index Ways of Coping Questionnaire ab: Purpose Health insurers offer plans covering a narrow subset of providers in an attempt to lower premiums and compete for consumers. However, narrow networks may limit access to high-quality providers, particularly those caring for patients with cancer. Methods We examined provider networks offered on the 2014 individual health insurance exchanges, assessing oncologist supply and network participation in areas that do and do not contain one of 69 National Cancer Institute (NCI)-Designated Cancer Centers. We characterized a network's inclusion of oncologists affiliated with NCI-Designated Cancer Centers relative to oncologists excluded from the network within the same region and assessed the relationship between this relative inclusion and each network's breadth. We repeated these analyses among networks offered in the same regions as the subset of 27 NCI-Designated Cancer Centers identified as National Comprehensive Cancer Network (NCCN) Cancer Centers. Results In regions containing NCI-Designated Cancer Centers, there were 13.7 oncologists per 100,000 residents and 4.9 (standard deviation [SD], 2.8) networks covering a mean of 39.4% (SD, 26.2%) of those oncologists, compared with 8.8 oncologists per 100,000 residents and 3.2 (SD, 2.1) networks covering on average 49.9% (SD, 26.8%) of the area's oncologists ( P < .001 for all comparisons). There was a strongly significant correlation ( r = 0.4; P < .001) between a network's breadth and its relative inclusion of oncologists associated with NCI-Designated Cancer Centers; this relationship held when considering only affiliation with NCCN Cancer Centers. Conclusion Narrower provider networks are more likely to exclude oncologists affiliated with NCI-Designated or NCCN Cancer Centers. Health insurers, state regulators, and federal lawmakers should offer ways for consumers to learn whether providers of cancer care with particular affiliations are in or out of narrow provider networks. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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