Tiered Physician Network Plans and Patient Choices of Specialist Physicians.

ABSTRACT:

Importance

Tiered physician network (TPN) health plans sort physicians into tiers based on their cost and quality, and patients pay lower copays for visits with physicians in the lower-cost and better-quality tiers. When the plans are first introduced, they lead patients to seek care from higher-value physicians.

Objectives

To examine whether TPNs are associated with patient choice of physician when the plans have been in place for 8 to 12 years and whether there are inequities in patient out-of-pocket costs associated with inequities in access to physicians in lower-copay tiers.

Design, setting, and participants

This cross-sectional study comprising 46 645 physicians and 585 399 patients in TPNs, including 54 683 patients who had a new patient visit with a physician

SUBMITTER: Prager E 

PROVIDER: S-EPMC10636632 | biostudies-literature | 2023 Nov

REPOSITORIES: biostudies-literature