Healthcare Economist December 3, 2023
Now that 51% of Medicare beneficiaries are enrolled in Medicare Advantage (MA), one key question is how restrictive are MA narrow networks? While beneficiaries enrolled in Medicare fee-for-service can choose any provider, MA plans can impose restrictions on enrollee’s provider choices. Measuring how restrictive an MA plan is, however, is difficult because “restrictiveness” is a concept that is difficult to quantify.
However, this is exactly what a paper by Feyman et al. (2023) aims to do. Their methodological approach uses Part D prescription drug event (PDE) and beneficiary claims data as well as geographic information from the Area Health Resource File (AHRF). Using these data, the authors developed a model:
…to predict the unique number of primary care providers...
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