Table 3:
Proportion of published analyses focused on tiered networks that reported an undesirable, equivalent, or desirable outcome (N=65 analyses).
| The Effect of Tiered Networks on… | Undesirable | Equivalent(no effect) | Desirable |
|---|---|---|---|
| Access to care outcomes analyzed | |||
|
| |||
| Distance to a provider (n=4) | - | 4 of 4 (100%) | - |
|
| |||
| Cost of care outcomes analyzed | |||
|
| |||
| Outpatient spending (n=3) | - | - | 3 of 3(100%)3 |
| Patient out of pocket/premiums (n=3) | - | - | 3 of 3(100%)3 |
| Hospital spending (n=3 | - | 3 of 3(100%)3 | - |
| Diagnostic spending (n=3) | - | - | 3 of 3(100%)3 |
| Total n=12 | 0 of 12 (0%) | 3 of 12(25%) | 9 of 12(75%) |
|
| |||
| Quality of care outcomes analyzed | |||
|
| |||
| Availability of high-quality providers (n=24) | 6 of 24 (25%) | 14 of 24 (58.3%)2 | 4 of 24 (6.7%)4 |
|
| |||
| Patient steering outcomes analyzed | |||
|
| |||
| Market share of providers in worst tier (n=11) | 6 of 11 (54.5%) | 2 of 11(18.2%) | 3 of 11 (27.3%) |
| Patient switching providers (n=8) | - | 8 of 8 (100%) | - |
| Market share of providers in top tier (n=6) | - | 6 of 6(100%) | - |
| Total n=25 | 6 of 25(24%) | 16 of 25 (64%) | 3 of 25 (12%) |
SOURCE: Authors’ analysis of published peer-reviewed studies from January 2000 to June 2020.
NOTES: Each discrete outcome extracted from included studies was coded as “desirable” (e.g. lower costs, better quality), “undesirable” (e.g. increased wait times to see a provider, higher re-admission), or “equivalent” (e.g. no difference in the outcome) based on the statistical analysis and conclusions of each study.
The superscripted number represents the number of analyses that used a quasi-experimental design in a given category. For example, 3 of the 3 analyses from quasi-experimental studies reported a desirable outcome in outpatient spending (decreased spending).