Networks In ACA Marketplaces Are Narrower For Mental Health Care Than For Primary Care.

There is increasing concern about the extent to which narrow-network plans, generally defined as those including fewer than 25 percent of providers in a given health insurance market, affect consumers' choice of and access to specialty providers--particularly in mental health care. Using data for 20...

Descripción completa

Detalles Bibliográficos
Publicado en:Health Affairs Vol. 36; no. 9; pp. 1624 - 1632
Autores principales: Zhu, Jane M., Yuehan Zhang, Polsky, Daniel
Formato: research tables/charts Journal Article
Publicado: Health Affairs Publishing, LLC Sep2017
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=125308717&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 125308717
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        02782715
        HAF
      jtl: Health Affairs
      issn: 02782715
      maglogo: N
    pubinfo:
      dt: Sep2017
      vid: 36
      iid: 9
      pid: 1453
      pub: Health Affairs Publishing, LLC
      place: Washington, District of Columbia
    artinfo:
      ui:
        125308717
        125308717
        125308717
        10.1377/hlthaff.2017.0325
        125308717
      ppf: 1624
      ppct: 8
      formats:
      tig:
        atl: Networks In ACA Marketplaces Are Narrower For Mental Health Care Than For Primary Care.
      aug:
        au:
          Zhu, Jane M.
          Yuehan Zhang
          Polsky, Daniel
        affil: National Clinician Scholar and fellow in the Division of General Internal Medicine at the University of Pennsylvania Perelman School of Medicine, in Philadelphia
      sug:
        subj:
          Patient Protection and Affordable Care Act
          Insurance, Health
          Mental Health Services
          Primary Health Care
          Health Insurance Exchanges
          Human
          Comparative Studies
          Descriptive Statistics
          Data Analysis Software
          Chi Square Test
          Spearman's Rank Correlation Coefficient
          Confidence Intervals
      ab: There is increasing concern about the extent to which narrow-network plans, generally defined as those including fewer than 25 percent of providers in a given health insurance market, affect consumers' choice of and access to specialty providers--particularly in mental health care. Using data for 2016 from 531 unique provider networks in the Affordable Care Act Marketplaces, we evaluated how network size and the percentage of providers who participate in any network differ between mental health care providers and a control group of primary care providers. Compared to primary care networks, participation in mental health networks was low, with only 42.7 percent of psychiatrists and 19.3 percent of nonphysician mental health care providers participating in any network. On average, plan networks included 24.3 percent of all primary care providers and 11.3 percent of all mental health care providers practicing in a given state-level market. These findings raise important questions about provider-side barriers to meeting the goal of mental health parity regulations: that insurers cover mental health services on a par with general medical and surgical services. Concerted efforts to increase network participation by mental health care providers, along with greater regulatory attention to network size and composition, could improve consumer choice and complement efforts to achieve mental health parity.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N