Going the extra mile? How provider network design increases consumer travel distance, particularly for rural consumers

Context: The practical accessibility to medical care facilitated by health insurance plans depends not just on the number of providers within their networks but also on distances consumers must travel to reach the providers. Long travel distances inconvenience almost all consumers and may substantially reduce choice and access to providers for some. Methods: The authors assess mean and median travel distances to cardiac surgeons and pediatricians for participants in (1) plans offered through Covered California, (2) comparable commercial plans, and (3) unrestricted open-network plans. The authors repeat the analysis for higher-quality providers. Findings: The authors find that in all areas, but especially in rural areas, Covered California plan subscribers must travel longer than subscribers in the comparable commercial plan; subscribers to either plan must travel substantially longer than consumers in open networks. Analysis of access to higher-quality providers show somewhat larger travel distances. Differences between ACA and commercial plans are generally substantively small. Conclusions: While network design adds travel distance for all consumers, this may be particularly challenging for transportation-disadvantaged populations. As distance is relevant to both health outcomes and the cost of obtaining care, this analysis provides the basis for more appropriate measures of network adequacy than those currently in use.

Files

Metadata

Work Title Going the extra mile? How provider network design increases consumer travel distance, particularly for rural consumers
Access
Open Access
Creators
  1. Simon F. Haeder
  2. David L. Weimer
  3. Dana B. Mukamel
License In Copyright (Rights Reserved)
Work Type Article
Publisher
  1. Journal of Health Politics, Policy and Law
Publication Date December 1, 2020
Publisher Identifier (DOI)
  1. https://doi.org/10.1215/03616878-8641591
Deposited November 29, 2021

Versions

Analytics

Collections

This resource is currently not in any collection.

Work History

Version 1
published

  • Created
  • Added Extra_Mile_Open_Access.pdf
  • Added Creator Simon F. Haeder
  • Added Creator David L. Weimer
  • Added Creator Dana B. Mukamel
  • Published
  • Updated
  • Updated