Provider networks and health plan premium variation.
Provider networks and health plan premium variation.
复制标题
提供商网络和健康计划保费变化。
DOI：
10.1111/1475-6773.13447
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发表时间：
2021
影响因子：
3.4
通讯作者：
Wu,Bingxiao
中科院分区：
文献类型：
--
作者：
Polsky,Daniel;Wu,Bingxiao
目的研究2016年在所有50个州和DC的《平价医疗法案》健康保险市场上，计划保费与医生网络广度、医院网络广度和医院网络质量之间的关系。计划保费和特征的数据来自2016年罗伯特伍德约翰逊基金会健康保险交易所（HIX）比较。提供商网络信息从Vericred获得。医院特征来自CMS医院比较和美国医院协会（AHA）调查。研究设计我们使用普通最小二乘回归分析了计划保费与医生网络宽度、医院网络宽度和医院网络质量的变化之间的关系，并考虑了州-评级区域固定效应和载体固定效应。主要发现计划保费与医师网络宽度和医院网络宽度呈正相关。我们发现了以下具有统计学意义的结果：医生网络宽度每增加一个标准差，保费就会增加2.8%或每年增加101美元；医院网络宽度每增加一个标准差，保费就会增加2.4%或每年增加86美元。保费与医院网络质量之间没有显著关联，这是通过医院星级评分和教学医院或全国前20名医院来衡量的。结论医师网络广度和医院网络广度对计划保费有正向影响。这两种类型的提供者网络广度的作用在数量上是相似的。保费似乎对医院网络质量不敏感。
Objective To examine how plan premiums are associated with physician network breadth, hospital network breadth, and hospital network quality on the Affordable Care Act's Health Insurance Marketplaces in all 50 states and the DC in 2016. Data Sources Data on plan premiums and characteristics came from 2016 Robert Wood Johnson Foundation Health Insurance Exchange (HIX) Compare. Provider network information was obtained from Vericred. Hospital characteristics were obtained from CMS Hospital Compare and the American Hospital Association (AHA) survey. Study Design We analyzed how plan premiums were associated with variations in physician network breadth, hospital network breadth, and hospital network quality using ordinary least square regressions with state‐rating area fixed effects and carrier fixed effects. Principal Findings Plan premiums were positively associated with physician network breadth and hospital network breadth. We find the following statistically significant results: a one standard deviation increase in physician network breadth was linked to a premium increase of 2.8 percent or 101peryear;aonestandarddeviationincreaseinhospitalnetworkbreadthwaslinkedtoapremiumincreaseof2.4percentor 86 per year. There was no significant association between premiums and hospital network quality, as measured by hospital star ratings and the inclusion of teaching hospitals or the top‐20 hospitals nationwide. Conclusions Physician network breadth and hospital network breadth contributed positively to plan premiums. The roles of the two types of provider network breadth are quantitatively similar. Premiums appear to be insensitive to hospital network quality.