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The association of insurance plan characteristics with physician patient-sharing network structure

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International Journal of Health Economics and Management Aims and scope Submit manuscript

Abstract

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.

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Acknowledgements

Preliminary results from this study were presented at the non-archival Symposium on Statistical Challenges in Electronic Commerce Research, Workshop on Information in Networks and the Academy Health Annual Research Meeting.

Funding

This research was supported by a research grant from the National Institute for Health Care Management (NIHCM) and by the Agency for Healthcare Research and Quality (5R03HS025515).

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Correspondence to Kimberley H. Geissler.

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No conflicts of interest exist for the authors.

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Geissler, K.H., Lubin, B. & Ericson, K.M.M. The association of insurance plan characteristics with physician patient-sharing network structure. Int J Health Econ Manag. 21, 189–201 (2021). https://doi.org/10.1007/s10754-021-09296-4

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  • DOI: https://doi.org/10.1007/s10754-021-09296-4

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