Table 2.
Descriptive Statistics of Managed Care Variables for Health Plans, Primary Care Offices, and Primary Physicians
| Percentile Ranges | |||||
|---|---|---|---|---|---|
| Direction1 | Average | 25 | 50 | 75 | |
| Health Plan Indexes | |||||
| Plan Managed Care Index | (−) | 38 | 7 | 46 | 63 |
| In-Network Benefits Index | (+) | 90 | 86 | 92 | 97 |
| Out-of-Network Benefits Index | (+) | 44 | 0 | 57 | 73 |
| Office Managed Care Index | Average | ||||
| Office Managed Care Index2 | (−) | 37 | 9 | 22 | 77 |
| Physician Managed Care Variables | Percent of Patients Seeing Primary Physicians with These Characteristics | ||||
| Payment by salary | (+) | 66% | |||
| Productivity bonus | (+) | 54% | |||
| Financial withhold for referral | (−) | 32% | |||
| Average number of AHCPR guidelines read or used | (0) | .67 | 0 | 0 | 1 |
A (+) indicates the managed care variable is expected to be associated with greater access to specialists; a (−) indicates lower access; and a (0) indicates either lower or greater access (Grembowski et al. 1998).
The office managed care index was constructed from five measures (Source: office manager survey). Patients were seen in offices that, on average, received 34% of their revenue from capitation. About 24% of patients were seen in offices where prior approval from the office's medical director was required before referring the patient to a specialist inside the office. About 61% of the patients were seen in offices where prior approval was required to refer outside the office, and almost half of the patients were seen in offices with referral guidelines (43%) or clinical guidelines for specific conditions (43%).