Phantom Networks: Discrepancies Between Reported And Realized Mental Health Care Access In Oregon Medicaid.

ABSTRACT: Understanding the extent to which beneficiaries can "realize" access to reported provider networks is imperative in mental health care, where there are significant unmet needs. We compared listings of providers in network directories against provider networks empirically constructed from administrative claims among members who were ages sixty-four and younger and enrolled in Oregon's Medicaid managed care organizations between January 1 and December 31, 2018. "In-network" providers were those with any medical claims filed for at least five unique Medicaid beneficiaries enrolled in a given health plan. They included primary care providers, specialty mental health prescribers, and nonprescribing mental health clinicians. Overall, 58.2 percent of network directory listings were "phantom" prov

SUBMITTER: Zhu JM 

PROVIDER: S-EPMC9876384 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature