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Consumer experience with a tiered physician network: early evidence
Anna D Sinaiko1, Meredith B Rosenthal
1Department of Healthcare Policy, Harvard University, 180 Longwood Ave, Boston, MA 02115, USA. asinaiko@hsph.harvard.edu
The American Journal of Managed Care
|February 13, 2010
Summary
Consumer awareness and trust in tiered provider networks are low, hindering their effectiveness in guiding patients to high-quality, cost-efficient physicians. Targeted education before physician selection is crucial for successful implementation.
Area of Science:
- Health Services Research
- Consumer Health Behavior
- Health Economics
Background:
- Tiered provider networks aim to guide consumers toward cost-efficient and high-quality healthcare providers.
- Understanding consumer perceptions of these networks is essential for their successful implementation and effectiveness.
Purpose of the Study:
- To analyze consumer awareness, use, and trust of tiered provider networks.
- To identify factors influencing consumer engagement with tiered networks.
Main Methods:
- A mail survey was conducted on a random sample of individuals enrolled in health plans.
- Statistical analyses, including chi-squared tests and logistic regression, were employed to examine demographic and characteristic effects.
Main Results:
- Nearly half of respondents were aware of tiered networks, with awareness higher among certain demographic and behavioral groups.
- A significant majority lacked trust in the networks to identify superior physicians.
- Information about physician tiering was often received after the first visit, diminishing its perceived importance.
Conclusions:
- Increased consumer awareness and trust in health plans as a source of provider rankings are necessary for tiered networks to direct consumers effectively.
- Proactive consumer education before physician selection is likely to enhance the impact and utility of tiered provider networks.
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