Professional and social connections among physicians impact patient outcomes, but little is known about how characteristics of insurance plans are associated with physician patient-sharing network structure. We use information from commercially insured enrollees in the 2011 Massachusetts All Payer Claims Database to construct and examine the structure of the physician patient-sharing network using standard and novel social network measures. Using regression analysis, we examine the association of physician patient-sharing network measures with an indicator of whether a patient is enrolled in a health maintenance organization (HMO) or preferred provider organization (PPO), controlling for patient and insurer characteristics and observed health status. We find patients enrolled in HMOs see physicians who are more central and densely embedded in the patient-sharing network. We find HMO patients see PCPs who refer to specialists who are less globally central, even as these specialists are more locally central. Our analysis shows there are small but significant differences in physician patient-sharing network as experienced by patients with HMO versus PPO insurance. Understanding connections between physicians is essential and, similar to previous findings, our results suggest policy choices in the insurance and delivery system that change physician connectivity may have important implications for healthcare delivery, utilization and costs.

医生之间的专业和社会联系会影响患者的治疗效果，但对于保险计划的特征如何与医生患者共享网络结构相关联知之甚少。我们使用来自 2011 年马萨诸塞州所有付款人索赔数据库中商业保险参保者的信息，使用标准和新颖的社交网络措施构建和检查医生患者共享网络的结构。使用回归分析，我们检查了医生患者共享网络测量与患者是否参加健康维护组织 (HMO) 或首选提供者组织 (PPO) 的指标之间的关联，控制患者和保险公司的特征以及观察到的健康状况. 我们发现参加 HMO 的患者看到的医生在患者共享网络中更为中心和密集。我们发现 HMO 患者看到的 PCP 指的是在全球范围内较不集中的专家，即使这些专家在当地更为中心。我们的分析表明，HMO 与 PPO 保险的患者所经历的医生患者共享网络存在微小但显着的差异。了解医生之间的联系至关重要，与之前的研究结果类似，我们的结果表明，改变医生连接的保险和交付系统中的政策选择可能对医疗保健的交付、利用和成本产生重要影响。我们的分析表明，HMO 与 PPO 保险的患者所经历的医生患者共享网络存在微小但显着的差异。了解医生之间的联系至关重要，与之前的研究结果类似，我们的结果表明，改变医生连接的保险和交付系统中的政策选择可能对医疗保健的交付、利用和成本产生重要影响。我们的分析表明，HMO 与 PPO 保险的患者所经历的医生患者共享网络存在微小但显着的差异。了解医生之间的联系至关重要，与之前的研究结果类似，我们的结果表明，改变医生连接的保险和交付系统中的政策选择可能对医疗保健的交付、利用和成本产生重要影响。