Restrictiveness of Medicare Advantage provider networks across physician specialties.

ABSTRACT:

Objective

The objective was to measure specialty provider networks in Medicare Advantage (MA) and examine associations with market factors.

Data sources and study setting

We relied on traditional Medicare (TM) and MA prescription drug event data from 2011 to 2017 for all Medicare beneficiaries in the United States as well as data from the Area Health Resources File.

Study design

Relying on a recently developed and validated prediction model, we calculated the provider network restrictiveness of MA contracts for nine high-prescribing specialties. We characterized network restrictiveness through an observed-to-expected ratio, calculated as the number of unique providers seen by MA beneficiaries divided by the number expected based on the prediction model. We assessed th

SUBMITTER: Feyman Y 

PROVIDER: S-EPMC11250170 | biostudies-literature | 2024 Aug

REPOSITORIES: biostudies-literature