Association Between Provider-Sponsored Health Plan Ownership and Health Insurance Marketplace Plan Quality.

ABSTRACT:

Background

Over 15.3 million Americans relied on the individual health insurance market for health coverage in 2021. Yet, little is known about the relationships between the organizational characteristics of individual market health insurers and quality of coverage, particularly with respect to clinical outcomes.

Objective

To examine variation in marketplace insurers' quality performance and investigate how performance varies by insurer organizational characteristics.

Design

Retrospective cohort study.

Participants

381 insurer products, representing 184 unique insurers in 50 states in 2019 and 2020.

Main measures

Marketplace plan clinical quality measures reported in the 2019-2020 CMS Plan Quality Rating System dataset and insurer-product organizational

SUBMITTER: Cai ST 

PROVIDER: S-EPMC9585138 | biostudies-literature | 2022 Nov

REPOSITORIES: biostudies-literature