A Consumer-Centric Approach To Network Adequacy: Access To Four Specialties In California's Marketplace.

We assessed the effect of provider networks on access to four medical specialties for Affordable Care Act Marketplace enrollees in California. Our approach incorporated a crucial consumer-focused attribute, travel distance, and identified the restrictions on provider access resulting from network de...

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Publicado en:Health Affairs Vol. 38; no. 11; pp. 1918 - 1927
Autores principales: Haeder, Simon F., Weimer, David, Mukamel, Dana B.
Formato: research tables/charts Journal Article
Publicado: Health Affairs Publishing, LLC Nov2019
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Health Affairs Publishing, LLC
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        atl: A Consumer-Centric Approach To Network Adequacy: Access To Four Specialties In California's Marketplace.
      aug:
        au:
          Haeder, Simon F.
          Weimer, David
          Mukamel, Dana B.
        affil: Assistant professor of public policy in the School of Public Policy at the Pennsylvania State University, in University Park
      sug:
        subj:
          Patient Centered Care Methods
          Health Services Accessibility
          Health Insurance Exchanges California
          Human
          California
          Health Information Networks
      ab: We assessed the effect of provider networks on access to four medical specialties for Affordable Care Act Marketplace enrollees in California. Our approach incorporated a crucial consumer-focused attribute, travel distance, and identified the restrictions on provider access resulting from network design. Our analysis indicated that Marketplace plan networks are narrower than their commercial plan counterparts and feature just over half as many providers. However, there is much diversity in network breadth, depending on consumers' choice of plans and geographic region. Furthermore, network designs often create important access issues for consumers because of what we call "artificial local provider deserts"--geographic areas within networks devoid of providers by design. Consumers in large metropolitan areas are generally guaranteed a significant degree of access and choice, but network design exacerbates limited access for rural areas in which few providers are available to any consumer.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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