September 14, 2016

Study Finds Health Plans Can Guide Higher-Spending Patients to Higher-Value Providers - New Research Insights

Tiered physician networks are one potential strategy to control health care costs while maintaining patient choice. Here’s how they work: health plans sort physicians into tiers based on the quality and cost-efficiency of the care they provide. Patients are incentivized by lower copayments to choose higher-tier physicians. A recent paper by Anna Sinaiko, supported by a NIHCM research grant, looks at whether tiers are actually influencing patient choice of physician. The study demonstrates that

  • older and sicker patients, who tend to have higher medical spending, do gravitate toward top-tier physicians when selecting a new doctor, but
  • changing an established physician relationship is more challenging for all types of patients.

NIHCM’s new one-page Research Insights highlights the key takeaways.