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Related Experiment Videos

Hypothetical Network Adequacy Schemes For Children Fail To Ensure Patients' Access To In-Network Children's Hospital.

Jeffrey D Colvin1, Matt Hall2, Cary Thurm3

  • 1Jeffrey D. Colvin ( jdcolvin@cmh.edu ) is an associate professor in the Division of General Academic Pediatrics, Children's Mercy Hospital, in Kansas City, Missouri.

Health Affairs (Project Hope)
|June 5, 2018
PubMed

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Summary

Nearly half of children's specialty hospitalizations exceed standard distance requirements. This highlights potential access issues with narrow network strategies in pediatric care, necessitating policy review.

Area of Science:

  • Health Services Research
  • Pediatric Healthcare Policy
  • Insurance Network Adequacy

Background:

  • Insurers are increasingly using narrow network strategies.
  • The impact of these strategies on children's access to specialized care is not well understood.

Purpose of the Study:

  • To assess pediatric specialty hospitalizations exceeding Medicare Advantage network distance requirements.
  • To evaluate a pediatric adaptation of these requirements.

Main Methods:

  • Analysis of 748,920 pediatric specialty hospitalizations from 81 children's hospitals (Oct 2014-Sep 2015).
  • Comparison against existing Medicare Advantage distance standards for adult care and a pediatric adaptation.

Main Results:

Keywords:
Access To CareChildren < InsuranceChildren's HealthInsurance Coverage < InsuranceLegal/Regulatory Issues

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  • Nearly 50% of hospitalizations fell outside standard Medicare Advantage distance requirements.
  • Under a pediatric adaptation, the percentage varied significantly across hospitals (0% to 35%).

    • Conclusions:

    • Existing distance standards may limit access to pediatric specialty care.
    • Policy makers should consider nuanced network definitions, including functional capabilities and exception policies, beyond simple time and distance.