Format

Send to:

Choose Destination
See comment in PubMed Commons below
Health Serv Res. 2011 Apr;46(2):437-56. doi: 10.1111/j.1475-6773.2010.01217.x. Epub 2010 Dec 9.

How do quality information and cost affect patient choice of provider in a tiered network setting? Results from a survey.

Author information

  • 1Department of Health Policy & Management, Harvard School of Public Health, Boston, MA 02115, USA.

Abstract

OBJECTIVE:

To assess how quality information from multiple sources and financial incentives affect consumer choice of physicians in tiered physician networks.

DATA SOURCE:

Survey of a stratified random sample of Massachusetts state employees.

STUDY DESIGN:

Respondents were assigned a hypothetical structure with differential copayments for "Tier 1" (preferred) and "Tier 2" (nonpreferred) physicians. Half of respondents were told they needed to select a cardiologist, and half were told they needed to select a dermatologist. Patients were asked whether they would choose a Tier 1 doctor, a Tier 2 doctor, or had no preference in a case where they had no further quality information, a case where a family member or friend recommended a Tier 2 doctor, and a case where their personal physician recommended a Tier 2 doctor. The effects of copayments, recommendations, physician specialty, and patient characteristics on the reported probability of selecting a Tier 1 doctor are analyzed using multinomial logit and logistic regression.

PRINCIPAL FINDINGS:

Relative to a case where there is no copayment differential between tiers, copayment differences of U.S.$10-U.S.$35 increase the number of respondents indicating they would select a Tier 1 physician by 3.5-11.7 percent. Simulations suggest copayments must exceed U.S.$300 to counteract the recommendation for a lower tiered physician from friends, family, or a referring physician. Sensitivity to the copayments varied with physician specialty.

CONCLUSIONS:

Tiered provider networks with these copayment levels appear to have limited influence on physician choice when contradicted by other trusted sources. Consumers' response likely varies with physician specialty.

© Health Research and Educational Trust.

PMID:
21143478
[PubMed - indexed for MEDLINE]
PMCID:
PMC3064913
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Blackwell Publishing Icon for PubMed Central
    Loading ...
    Write to the Help Desk