TY - JOUR
T1 - Potemkin Protections
T2 - Assessing Provider Directory Accuracy and Timely Access for Four Specialties in California
AU - Burman, Abigail
AU - Haeder, Simon F.
N1 - Publisher Copyright:
© 2022 Duke University Press. All rights reserved.
PY - 2022/6/1
Y1 - 2022/6/1
N2 - Context: The accuracy of provider directories and whether consumers can schedule timely appointments are crucial determinants of health access and outcomes. Methods:We evaluated accuracy and timely access data obtained fromthe CaliforniaDepartment of Managed Health Care, consisting of responses to large, random, representative surveys of primary care providers, cardiologists, endocrinologists, and gastroenterologists for 2018 and 2019 for all managed care plans in California. Findings: Surveys were able to verify provider directory entries for the four specialties for 59% to 76% of listings or 78% to 88% of providers reached. We found that consumers were able to schedule urgent care appointments for 28% to 54% of listings or 44% to 72% of accurately listed providers. For general care appointments, the percentages ranged from 35% to 64% of listed providers or 51% to 87% of accurately listed providers. Differences across markets related to accuracy were generally small. Medi-Cal plans outperformed othermarketswith regard to timely access. Primary care consistently outperformed all other specialties. Timely access rates were higher for general appointments than for urgent care appointments. Conclusions: Our finding raise questions about the regulatory regime as well as consumer access and health outcomes.
AB - Context: The accuracy of provider directories and whether consumers can schedule timely appointments are crucial determinants of health access and outcomes. Methods:We evaluated accuracy and timely access data obtained fromthe CaliforniaDepartment of Managed Health Care, consisting of responses to large, random, representative surveys of primary care providers, cardiologists, endocrinologists, and gastroenterologists for 2018 and 2019 for all managed care plans in California. Findings: Surveys were able to verify provider directory entries for the four specialties for 59% to 76% of listings or 78% to 88% of providers reached. We found that consumers were able to schedule urgent care appointments for 28% to 54% of listings or 44% to 72% of accurately listed providers. For general care appointments, the percentages ranged from 35% to 64% of listed providers or 51% to 87% of accurately listed providers. Differences across markets related to accuracy were generally small. Medi-Cal plans outperformed othermarketswith regard to timely access. Primary care consistently outperformed all other specialties. Timely access rates were higher for general appointments than for urgent care appointments. Conclusions: Our finding raise questions about the regulatory regime as well as consumer access and health outcomes.
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U2 - 10.1215/03616878-9626866
DO - 10.1215/03616878-9626866
M3 - Article
C2 - 34847230
AN - SCOPUS:85131107526
SN - 0361-6878
VL - 47
SP - 319
EP - 349
JO - Journal of health politics, policy and law
JF - Journal of health politics, policy and law
IS - 3
ER -