ArticleHealth services research2024
Restrictiveness of Medicare Advantage provider networks across physician specialties.
Article in Health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
15 citing papers in PubMed, 20 citations in OpenAlex.
- Quality, Cost, and Timeliness of Cancer Treatment in Medicare Advantage and Traditional Medicare.JAMA internal medicine · 2026Article
- Timeliness of antiresorptive consolidation after anabolic therapy for primary fracture prevention: A US cohort study.The Journal of clinical endocrinology and metabolism · 2026Article
- Characteristics of urologists participating in Medicare Advantage networks and implications for prostate cancer care.Health affairs scholar · 2026Article
- Oncology Organization and Oncologist Networks Under Medicare Advantage Plans.JAMA network open · 2026Article
- Surgery at High-Quality Hospitals Among Medicare Advantage Beneficiaries Undergoing Cancer Surgery.JAMA surgery · 2025Article
- Mental health care use after leaving Medicare Advantage for traditional Medicare.The American journal of managed care · 2025Article
- From Disappointment to Predominance: Medicare Advantage's Ascendancy and Transformation of Medicare.The Milbank quarterly · 2025Article
- Expansion and Marketing of Medicare Advantage to Persons With End-Stage Kidney Disease.JAMA network open · 2025Article
- Financial burden of care greatest among rural beneficiaries in Medicare advantage.Health services research · 2025Article
- Medicare Advantage Dental Benefits: Comprehensive Coverage Available In Fewer Than Half Of US Counties.Health affairs (Project Hope) · 2025Article
- Dialysis Facility Participation In Medicare Advantage Networks Was Highest For Large Dialysis Organizations In 2021.Health affairs (Project Hope) · 2025Article
- The Promise and Perils of Oncology Care in Medicare Advantage.JAMA network open · 2024Article
- Restrictiveness of Medicare Advantage provider networks across physician specialties.Health services research · 2024Article
- Medicare Advantage Enrollment and Total Medicare Program Spending.Inquiry : a journal of medical care organization, provision and financingArticle
- Cancer in rural America: Improving access to clinical trials and quality of oncologic care.CA: a cancer journal for cliniciansReview
Corrections and comments
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Authors and funding
6 authors at 5 institutions in 1 country.
Funding
Abstract
objectiveThe objective was to measure specialty provider networks in Medicare Advantage (MA) and examine associations with market factors. DATA SOURCES AND STUDY
settingWe relied on traditional Medicare (TM) and MA prescription drug event data from 2011 to 2017 for all Medicare beneficiaries in the United States as well as data from the Area Health Resources File. STUDY
designRelying on a recently developed and validated prediction model, we calculated the provider network restrictiveness of MA contracts for nine high-prescribing specialties. We characterized network restrictiveness through an observed-to-expected ratio, calculated as the number of unique providers seen by MA beneficiaries divided by the number expected based on the prediction model. We assessed the relationship between network restrictiveness and market factors across specialties with multivariable linear regression. DATA COLLECTION/EXTRACTION
methodsPrescription drug event data for a 20% random sample of beneficiaries enrolled in prescription drug coverage from 2011 to 2017. PRINCIPAL
findingsProvider networks in MA varied in restrictiveness. OB-Gynecology was the most restrictive with enrollees seeing 34.5% (95% CI: 34.3%-34.7%) as many providers as they would absent network restrictions; cardiology was the least restrictive with enrollees seeing 58.6% (95% CI: 58.4%-58.8%) as many providers as they otherwise would. Factors associated with less restrictive networks included the county-level TM average hierarchical condition category score (0.06; 95% CI: 0.04-0.07), the county-level number of doctors per 1000 population (0.04; 95% CI: 0.02-0.05), the natural log of local median household income (0.03; 95% CI: 0.007-0.05), and the parent company's market share in the county (0.16; 95% CI: 0.13-0.18). Rurality was a major predictor of more restrictive networks (-0.28; 95% CI: -0.32 to -0.24).
conclusionsOur findings suggest that rural beneficiaries may face disproportionately reduced access in these networks and that efforts to improve access should vary by specialty.
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