There’s been a lot of talk about "narrow" networks in ACA plans, which trade off limited provider coverage for lower premiums. Using a new integrated dataset of physician networks in plans on the federal and state marketplaces, our latest LDI/RWJF Data Brief describes the breadth of physician networks across all silver plans sold in 2014.
The Affordable Care Act (ACA) has prompted health plans to increase their use of “narrow networks” of providers as a cost containment strategy. The Leonard Davis Institute of Health Economics (LDI) has assembled the first integrated dataset of physician networks for the plans offered on the ACA marketplace. This data brief uses this new resource to describe the breadth of the physician networks in plans sold on the state and federal marketplaces.
Cross-posted with the Philadelphia Inquirer
Imagine a woman in labor who goes to the hospital with a delivery plan she made in consultation with her obstetrician: yes to antibiotics in labor; no to an epidural for pain control; yes to neonatal circumcision; and yes to having an intrauterine device (IUD) placed immediately after childbirth.
Cross-posted with the Field Clinic blog
Over the past two years, one of the top health care priorities in Philadelphia has been getting people signed up for health insurance. That is still a huge, unfinished task, but alongside it we need to make sure we have enough doctors in the right places to deliver care. For health care reform to deliver on its promise, people need good access to primary care.
Depending on your neighborhood in Philadelphia, you may face a 10-fold difference in the supply of primary care practices located close to your home. This is the finding of a new study commissioned by the Philadelphia Department of Public Health and conducted by a research team that I headed.
Primary care is critically important for improving health outcomes and promoting public health. LDI Senior Fellows conduct research on primary care that digs deeper into the different components of access - the related but separate concepts of availability, accessibility, accommodation, affordability and acceptability.
Although the ACA has cut the level of uninsurance dramatically, roughly 30 million adults remain uninsured, many of them in states that did not expand Medicaid. Can these self-pay patients get an appointment with a primary care provider, and if so, at what price?
Neighborhood Social Environment and Patterns of Adherence to Oral Hypoglycemic Agents Among Patients With Type 2 Diabetes Mellitus
In Family and Community Health, Heather F. de Vries and colleagues, including Douglas Wiebe and Dylan Small, examine whether social environment is related to adherence to oral hypoglycemic agents among patients with type 2 diabetes mellitus. While individual characteristics are important contributors to medication adherence, much of the observed variation in adherence rates remains unexplained by these factors De Vries and colleagues compare residents in neighborhoods with high social affluence, high residential stability, and high neighborhood advantage to residents of...
Understanding Low-Income African American Women's Expectations, Preferences, and Priorities in Prenatal Care
In Family and Community Health, Judy Shea and colleagues seek to better understand low-income African-American women’s views on prenatal care. The analysis is the result a focus group study using a community-based participatory research framework. Shea and colleagues find that that friends/family and the baby’s health were the top factors that encouraged prenatal care attendance. Barriers to getting prenatal care included insurance, transportation, and ambivalence as to its importance. Facilitators included transportation services, social support, and education about available resources....
Sunday, March 8th is International Women’s Day. Take part in the Twitter conversation with #womensday and #makeithappen
In Milbank Quarterly, Peter Groeneveld and Nancy Kressin (Boston University) share their systematic review of the available literature on overuse of care and ethnicity. While many studies have looked at racial disparities in access to care, fewer have examined racial disparities in overuse of care. Analyzing 74 study outcomes (from 59 unique studies), the authors find that 32 outcomes indicate greater overuse by white patients, 9 find greater overuse by minorities, and 33 show no relationship between race and overuse of medical care. These results demonstrate that overuse of care is not...
In Neurology, Michael Mullen, Charles Branas, Brendan Carr and colleagues share results of a virtual simulation focused on access to comprehensive stroke centers (CSCs), which are critical to ensuring access to stroke treatment. For their virtual trial, the authors selectively converted primary stroke centers (PSCs) to CSCs. Up to 20 PSCs per state were selected for conversion to CSCs, attempting to maximize the amount of the population with 60-minute CSC access by ground or air. Access was then compared across states. In 2010, the Joint Commission Survey found that 65.8 percent of the U.S...