Breadth and Exclusivity of Hospital and Physician Networks in US Insurance Markets.

ABSTRACT:

Importance

Little is known about the breadth of health care networks or the degree to which different insurers' networks overlap.

Objective

To quantify network breadth and exclusivity (ie, overlap) among primary care physician (PCP), cardiology, and general acute care hospital networks for employer-based (large group and small group), individually purchased (marketplace), Medicare Advantage (MA), and Medicaid managed care (MMC) plans.

Design, setting, and participants

This cross-sectional study included 1192 networks from Vericred. The analytic unit was the network-zip code-clinician type-market, which captured attributes of networks from the perspective of a hypothetical patient seeking access to in-network clinicians or hospitals within a 60-minute drive.

Exposur

SUBMITTER: Graves JA 

PROVIDER: S-EPMC7747020 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature