Tiered network health plans and changes in physician practice intensity

Area of Science:

• Health Economics
• Healthcare Management
• Health Services Research

Background:

• Tiered physician networks incentivize lower resource utilization.
• Physician behavior may change with comparative performance feedback.

Purpose of the Study:

• To assess if physicians alter care intensity after receiving peer comparison data.
• To evaluate the effectiveness of tiered network informational interventions.

Main Methods:

• Utilized administrative data from 2010-2015 for physicians in a Massachusetts tiered network.
• Employed difference-in-differences regression analyzing 21,086 physicians across seven specialties.
• Compared physicians with high vs. low exposure to tiered network incentives based on revenue share.

Main Results:

• No statistically significant changes in overall physician care intensity were observed.
• Subcomponent analyses of physician services, facility, and pharmaceutical intensity also showed no significant differences.
• Informational interventions within tiered networks did not demonstrably alter physician resource utilization.

Conclusions:

• Tiered network incentives, based on care intensity, had no detectable impact on physician behavior.
• Providing physicians with comparative intensity data did not lead to changes in resource use.
• Further research may be needed to explore alternative strategies for influencing physician practice patterns.