Provider networks and primary‐care signups: do they restrict the use of medical services?

Partha Deb and Pravin Trivedi

Health Economics, 2009, vol. 18, issue 12, 1361-1380

Abstract: This article analyzes the effect of gatekeeper and network restrictions on use of health‐care services using simulation‐based estimation methods. Data from the Community Tracking Survey (1996–1997) show significant evidence of selection into plans with gatekeeper and/or network restrictions. Enrollees in plans with networks of physicians have fewer office‐based visits to non‐physician medical professionals, but more emergency room visits and hospital stays. Individuals in plans that require signups with a primary‐care provider have more visits to non‐physician providers of care, more surgeries and hospital stays but substantially fewer emergency room visits. Enrollees of plans that do not pay for out‐of‐network services have more office‐based and emergency room visits, but less surgeries and hospitalizations. Copyright © 2008 John Wiley & Sons, Ltd.

Date: 2009
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

Downloads: (external link)
https://doi.org/10.1002/hec.1432

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:wly:hlthec:v:18:y:2009:i:12:p:1361-1380

Access Statistics for this article

Health Economics is currently edited by Alan Maynard, John Hutton and Andrew Jones

More articles in Health Economics from John Wiley & Sons, Ltd.
Bibliographic data for series maintained by Wiley Content Delivery ().