Literature DB >> 33877776

Regulation of provider networks in response to COVID-19.

Kelly E Anderson1, Lisa R Shugarman, Karen Davenport.   

Abstract

In public health insurance programs, federal and state regulators use network adequacy standards to ensure that health plans provide enrollees with adequate access to care. These standards are based on provider availability, anticipated enrollment, and patterns of care delivery. We anticipate that the coronavirus disease 2019 pandemic will have 3 main effects on provider networks and their regulation: enrollment changes, changes to the provider landscape, and changes to care delivery. Regulators will need to ensure that plans adjust their network size should there be increased enrollment or increased utilization caused by forgone care. Regulators will also require updated monitoring data and plan network data that reflect postpandemic provider availability. Telehealth will have a larger role in care delivery than in the prepandemic period, and regulators will need to adapt network standards to accommodate in-person and virtual care delivery.

Entities:  

Mesh:

Year:  2021        PMID: 33877776      PMCID: PMC8872119          DOI: 10.37765/ajmc.2021.88614

Source DB:  PubMed          Journal:  Am J Manag Care        ISSN: 1088-0224            Impact factor:   3.247


  12 in total

1.  The effect of narrow provider networks on health care use.

Authors:  Alicia Atwood; Anthony T Lo Sasso
Journal:  J Health Econ       Date:  2016-09-21       Impact factor: 3.883

2.  Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2019. Final rule.

Authors: 
Journal:  Fed Regist       Date:  2018-04-17

3.  The Impact of Economic Conditions on Participation in Disability Programs: Evidence from the Coal Boom and Bust.

Authors:  Dan Black; Kermit Daniel; Seth Sanders
Journal:  Am Econ Rev       Date:  2002

4.  Going the Extra Mile? How Provider Network Design Increases Consumer Travel Distance, Particularly for Rural Consumers.

Authors:  Simon F Haeder; David L Weimer; Dana B Mukamel
Journal:  J Health Polit Policy Law       Date:  2020-12-01       Impact factor: 2.265

Review 5.  Primary Care Practice Finances In The United States Amid The COVID-19 Pandemic.

Authors:  Sanjay Basu; Russell S Phillips; Robert Phillips; Lars E Peterson; Bruce E Landon
Journal:  Health Aff (Millwood)       Date:  2020-06-25       Impact factor: 6.301

6.  Relation Between Narrow Networks and Providers of Cancer Care.

Authors:  Laura Yasaitis; Justin E Bekelman; Daniel Polsky
Journal:  J Clin Oncol       Date:  2017-07-05       Impact factor: 44.544

7.  Telehealth Utilization in Response to the Novel Coronavirus (COVID-19) Pandemic in Orthopaedic Surgery.

Authors:  Robert L Parisien; Max Shin; Michael Constant; Bryan M Saltzman; Xinning Li; William N Levine; David P Trofa
Journal:  J Am Acad Orthop Surg       Date:  2020-06-01       Impact factor: 3.020

8.  Reports of Forgone Medical Care Among US Adults During the Initial Phase of the COVID-19 Pandemic.

Authors:  Kelly E Anderson; Emma E McGinty; Rachel Presskreischer; Colleen L Barry
Journal:  JAMA Netw Open       Date:  2021-01-04

9.  Disability Insurance and the Great Recession.

Authors:  Nicole Maestas; Kathleen J Mullen; Alexander Strand
Journal:  Am Econ Rev       Date:  2015-05

10.  Comparison of Office-Based Physician Participation in Medicaid Managed Care and Health Insurance Exchange Plans in the Same US Geographic Markets.

Authors:  Jacob Wallace; Anthony Lollo; Chima D Ndumele
Journal:  JAMA Netw Open       Date:  2020-04-01
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