Healthcare Economist April 17, 2024
Medicare Advantage (MA) plans have a number of advantages and drawbacks over traditional Medicare (TM) (i.e., fee-for-service). One advantage of MA plans is that cost sharing is often lower. Another benefit is that enrollees may receive additional coverage benefits. One drawback is that enrollee provider choice may be restricted. Fewer provider options may be bad for some patients, but it does lower premiums if the narrow network has lower reimbursement rates (see Dafny et al. 2017). A key empirical question is how restrictive are Medicare Advantage provider networks?
This is the question Feyman et al. (2024) aim to answer. Using 2011-2017 Medicare claims and Medicare Advantage prescription drug event (PDE) data, the authors measure network restrictiveness for nine high-prescribing specialties....
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